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PCIs No Better Than Medical Therapy in 'Nonacute' CAD
Percutaneous coronary interventions appear no better than medical therapy for preventing MI or death in patients with "nonacute" coronary artery disease, according to a Lancet meta-analysis.
Researchers examined data from 63 randomized, controlled trials comparing at least two of the following treatments: medical therapy, percutaneous transluminal balloon coronary angioplasty, bare-metal stents, and drug-eluting stents. More than 25,000 patients with nonacute CAD were included (defined as those with stable and unstable angina, and excluding those with acute MI).
During a median follow-up of 12 months, neither balloon angioplasty nor stenting proved better than medical therapy for reducing MI and mortality. (Stenting generally outperformed balloon angioplasty in terms of preventing coronary artery bypass grafting and revascularization.)
The authors say their results "lend support to present recommendations to optimise medical therapy as an initial management strategy" for patients with nonacute CAD.
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Published in Physician's First Watch March 13, 2009
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