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American Heart Association 2008 Wrap-Up Report: Top Research Advances Include Studies That Influence Medical Care, Apply Science To 'Real World' Communities
Date:1/21/2009

tp://www.eurheartj.oxfordjournals.org/" target="_new">www.eurheartj.oxfordjournals.org.

Funding: Edwards Lifesciences provided an unrestricted grant for the practical organization of the meeting.

6. Stable coronary artery disease: what treatment is optimal?

Effect of PCI on quality of life in patients with stable coronary disease

Advances in the technology underlying percutaneous coronary interventions have allowed an approach to more technically difficult vessels, and this has encouraged the use of PCI for treating stable angina. Indeed, the presence of a lesion has almost seemed to mandate that it be corrected. However, head-to-head comparisons with optimal medical treatment have not been done. In the COURAGE trial, patient outcomes, including quality of life, after PCI with optimized medical therapy were compared with patient outcomes of those on optimized medical therapy alone who had stable coronary disease. Both patients treated with PCI and medical therapy and those treated with medical therapy alone had marked improvements in health status during follow-up, suggesting that many patients currently are not receiving optimized medical treatment. Although the PCI group had small, but significant, incremental benefits during the first two years, by 36 months there was no difference in health status. This trial should lead to more aggressive medical treatment of patients with stable coronary disease, and more thoughtful utilization of PCI.

Source: New England Journal of Medicine, Aug. 14, 2008; N Engl J Med 2008:359: 677-87. www.nejm.org.

Funding: No specific funding of this study was noted, although full author disclosures are available on the manuscript.

7. Selecting patients for prevention.

Rosuvastatin to prevent vascu
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