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

neous 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
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