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Written By: Editorial Team | Updated : May 22, 2014 1:47 AM IST
Scientists have found that treating the patients who are currently suffering from stable coronary artery disease, but haven't experienced a heart attack or an abnormal stress test, after undergoing an angioplasty may not see any additional benefits compared to drug therapy alone.
A survey which has been done on more than 4,000 patients with myocardial ischemia by the cardiologists of Stony Brook University School of Medicine, aimed to design a data study that combined data from clinical trials performed between 1970 and 2012 of patients who had either percutaneous coronary intervention (PCI), or angioplasty, plus drug therapy, or drug therapy alone to treat their CAD.
Each of the clinical studies within the analysis reported outcomes of death and nonfatal myocardial infarction. Additionally, to reflect contemporary medical and interventional practice, the scientists made sure that 50 percent of the patients in the study had undercone a stent implantation of the PCI procedures and were on statin medications to lower their cholesterol levels. (Read: Bioabsorbable stents the future of angioplasty?)
This led to a total of five clinical trials yielding 4,064 patients with myocardial ischemia diagnosed by exercise stress testing, nuclear or echocardiocraphic stress imaging, or fractional flow reserve.
The researchers reviewed outcomes data up to five years post PCI or drug treatment alone. They analyzed all-cause death, non-fatal myocardial infarction, unplanned revascularization, and angina in the patients.
The analysis showed all-cause death rates between the two groups was not significantly different 6.5 percent for patients receiving PCI and drug therapy versus 7.3 percent for patients receiving drug therapy alone.
There was little difference in the rates of non-fatal myocardial infarction (9.2 percent with PCI vs. 7.6 percent drug therapy) and recurrent or persistent angina (20.3 percent vs. 23.3). (Read: Angioplasty is safe for the elderly (Expert speak))
Read more about causes, symptoms, diagnosis and treatment of heart disease.
The research is published online in JAMA Internal Medicine.
What is angioplasty?
Angioplasty is the mechanical widening of a narrowed or totally-obstructed blood vessel. When a person suffers a heart attack, ideally, treatment in the form of angioplasty must be provided within the first 1-1.5 hours (the golden hour). Anything beyond this time frame and the heart muscle cells are irreversibly damaged. This type of angioplasty is called a PAMI or Primary Angioplasty. (Read more: Angioplasty indications, procedure, risks)
With inputs from ANI
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