Navigation Links
Drug Therapy for Artery Disease Underused, Study Says
Date:5/10/2011

By Serena Gordon
HealthDay Reporter

TUESDAY, May 10 (HealthDay News) -- Fewer than 50 percent of people scheduled to have a stent placed in one of their coronary arteries for stable coronary artery disease received so-called optimal medical therapy -- drug therapy, such as statins -- before the procedure, according to new research.

This finding comes despite previous research, published in the New England Journal of Medicine four years ago, that found that optimal medical therapy was similarly effective to the stent procedure in preventing future cardiac problems.

That study was dubbed the COURAGE trial, and it included heart centers from across the United States. The study cost $33.5 million to conduct, and researchers hoped their findings would prompt more doctors to try medical therapy first in people with stable heart disease.

"The data shows that results are similar whether you treat with a stent or with medications in those with stable coronary disease," said the lead author of the new study, Dr. William Borden, a cardiologist at the Perelman Heart Institute at New York-Presbyterian/Weill Cornell Medical Center in New York City.

"When we looked at results before and after the COURAGE trial, the release of COURAGE didn't change practice patterns, and it seems that this is a real opportunity to look at how we deliver care to patients. For doctors, we need to make sure patients are on optimal medical therapy first. And, for policy makers, this study is an opportunity to look at how medical research trials are being translated into practice," Borden added.

Results of the new study are published in the May 11 issue of the Journal of the American Medical Association.

To get a better idea of how clinical trial results translate into practice, Borden and his colleagues reviewed data from the National Cardiovascular Data Registry on patients who were scheduled to undergo percutaneous coronary intervention -- stent placement. The registry included 1,013 U.S. hospitals, according to the study.

The registry also included data on 467,211 people who received a stent between 2005 and 2009. The new study included 173,416 people who received a stent before the COURAGE trial and 293,795 who received their stent after the COURAGE results were published.

Before COURAGE, 43.5 percent of patients were on optimal medical therapy before stenting. After the COURAGE trial, 44.7 percent received optimal medical therapy before undergoing a stenting procedure, the investigators found.

Optimal medical therapy generally included a beta blocker medication, a cholesterol-lowering statin drug and aspirin therapy, according to the study.

Borden said optimal medical therapy provides people with stable coronary artery disease the most benefit, particularly in the long-term. But it is not the first treatment of choice for people who are having a heart attack, he noted.

When the researchers behind the new study looked at how many people received optimal medical therapy after the stenting procedure both before and after COURAGE, they found similar results. Before COURAGE, 63.5 percent were given optimal medications, including an anti-platelet medication to discourage clot formation. And, after COURAGE, 66 percent were given optimal drug therapy, the findings showed.

That translates to a net benefit of 1.2 percent for medication therapy used before stenting, and 2.5 percent optimal drug therapy after stenting based on the COURAGE trial.

"I was surprised that in patients who have known coronary artery disease, who could benefit dramatically from being on the appropriate medications, that the right medicines weren't being used," said Borden.

Dr. James Slater, director of the cardiac catheterization laboratory at NYU Langone Medical Center in New York City, said, "The real message from COURAGE was that you don't need to use catheterization procedures in patients on optimal medical therapy for stable coronary artery disease."

Slater said that to really see the effects of COURAGE, the authors of the new study needed to include people who received optimal medical therapy and never needed to be referred for a stenting procedure.

"It would've been better if they also had people who didn't go on to have angioplasty," he said.

Borden said there are likely patients who are receiving the right drugs and are never referred for stenting, but it was important to look at the group referred for stenting as well. Ideally, all of the people referred for stenting should have already been placed on optimal medical therapy to see if their symptoms improved, he said.

More information

Learn more about angina from the American Heart Association.

SOURCES: William Borden, M.D., cardiologist, Perelman Heart Institute, New York-Presbyterian/Weill Cornell Medical Center, New York City; James Slater, M.D., director, cardiac catheterization laboratory, NYU Langone Medical Center, New York City; May 11, 2011, Journal of the American Medical Association


'/>"/>
Copyright©2010 ScoutNews,LLC.
All rights reserved

Related medicine news :

1. Nicotine replacement therapy is over-promoted since most ex-smokers quit unassisted
2. Social Anxiety and Panic - Alternative Treatment to Drugs and Therapy
3. Longview Therapy Center, PLLC, Unveils Its Definition Of Hope
4. Short-term radiation therapy successful on breast cancer
5. ASCROs Response to NY Times Articles on Radiation Therapy Incidents
6. Children With Cerebral Palsy Benefitting From New Physical Therapy Regimen
7. DavisPTnetwork Partners with the New York Physical Therapy Association to Provide Online Continuing Education
8. Behavioral therapy improves sleep and lives of patients with pain
9. WHI data confirm short-term heart disease risks of combination menopausal hormone therapy
10. Promising therapy for relapsing multibple sclerosis
11. Split-course palliative radiotherapy confirmed as effective treatment for advanced NSCLC
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:2/5/2016)... Dickson, Tennessee (PRWEB) , ... February 05, 2016 ... ... State Community College President George H. Van Allen have signed a joint enrollment ... semester, provides a seamless pathway toward associate and baccalaureate degrees at FHU|Dickson. ...
(Date:2/5/2016)... ... February 05, 2016 , ... In the fourth quarter ... gathered at the La Valencia Hotel in San Diego, California to discuss changes ... the year’s most outstanding franchise, walking away with the coveted David Wright Award ...
(Date:2/5/2016)... ... , ... Boar’s Head Brand®, one of the nation’s leading providers of premium ... the stress out of your party preparation – follow these easy, yet delicious recipes ... the game. , “The key to hosting a successful game-day party is creating a ...
(Date:2/5/2016)... ... February 05, 2016 , ... Stuart Bentkover, MD, FACS is ... to provide the most effective tattoo removal today, Dr. Bentkover is the only doctor ... by Cynosure, the PicoSure has been approved by the Food and Drug Administration (FDA) ...
(Date:2/5/2016)... ... February 05, 2016 , ... Health and wellness is a topic that should ... event they are experiencing an illness. Migraines are a severe form of a headache ... migraines would not wish the pain on their worst enemy, the feeling can last ...
Breaking Medicine News(10 mins):
(Date:2/5/2016)... Feb. 5, 2016  Aralez Pharmaceuticals Inc. ("Aralez") today ... Inc. ("POZEN") and Tribute Pharmaceuticals Canada Inc. ("Tribute") following approval ... of Tribute. The combined company will operate under Aralez ... operations in Canada , ... . Under the terms of the Agreement and ...
(Date:2/5/2016)... Feb. 5, 2016  Venice,s newest laser clinic, ... first of its kind in the area and ... advanced laser treatment. The physician-owned and operated laser ... Suncoast by storm with its revitalizing skin care ... multi-wavelength Astanza Trinity technology. http://photos.prnewswire.com/prnh/20160204/329957 ...
(Date:2/5/2016)... WARSAW, Ind. , Feb. 5, 2016  Zimmer ... the pricing of the previously announced underwritten secondary offering ... of its stockholders, consisting of affiliates of Blackstone and ... public at an initial price of $96.45 per share. ... of the offering.  Neither Zimmer Biomet nor any of ...
Breaking Medicine Technology: