Coronary artery disease (or heart disease) is characterized by plaque build up in the arteries, leading to oxygen deprivation in the heart muscle, chronic chest pain and heart attacks. Each year, hundreds of thousand of Americans with heart disease undergo angioplasty with stent procedures to open up the arteries of the heart. Yet for patients with stable heart disease there has not been sufficient evidence that stent treatment is significantly better than drug therapy alone. Now research reports that drug treatment is just as effective as a stent procedure in reducing the risk of death and heart attacks in patients with stable heart disease. However, the study authors stress that angioplasty with stents is a proven treatment for patients suffering from a heart attack or with chest pain that suddenly becomes worse.
The study, presented at the 2007 annual meeting of the American College of Cardiology and published in The New England Journal of Medicine, examined whether drug therapy and angioplasty with stents were superior to drug therapy alone in reducing the risk of heart attack and death. Researchers from Buffalo General Hospital administered drug therapy to 2,287 patients with stable heart disease, chest pain and 70 percent blockage in one or more heart arteries. About half of the participants also had angioplasty with stents (percutaneous coronary intervention or PCI).
The researchers found that 19 percent of participants in both groups died or had a heart attack over the five year follow-up period. Furthermore, there were no significant differences between both groups for stroke, hospitalization for acute coronary syndrome, or myocardial infarction. Although the angioplasty group initially reported a better quality of life and less episodes of chest pain following PCI, the differences diminished over the five year follow-up period.
"As an initial management strategy in patients with stable coronary artery disease, PCI did not reduce the risk of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy," the study authors conclude.
REFERENCES:
1. Boden W et al. Optimal Medical Therapy with or without PCI for Stable Coronary Disease, March 28,2007; vol356, released online ahead of publication.
Posted by Elaine Gavalas on March 30, 2007 03:03 PM
