Navigation Links
To Stent or Not: Is That the Question?

Reporting of COURAGE study results confused the public about the need and benefits of angioplasty

PORTLAND, Ore., June 07, 2007 /PRNewswire/ -- The onslaught of anti-stent news reports over the past few months has shaped the public's view that angioplasty doesn't work and its use should decrease. Confused by the media coverage, patients have extensively questioned their cardiologists about the benefits of stenting.

"Doctor and patient dialogue is always good," said Dr. Skip Freedman, Executive Medical Director for AllMed Healthcare Management. "But there's really no controversy over the COURAGE study, because it says that nothing has really changed." COURAGE is short for the full study name Clinical Outcomes Utilizing Revascularization and Aggressive Guideline Driven Drug Evaluation.

Many consumers have misread stories in the press about stents and angioplasty as involving patients undergoing a heart attack and in dire need of either angioplasty or clot-busting medications. But this wasn't the case. The COURAGE study looked at only rather low-risk patients who are in a stable condition.

The real message is that the study reinforces long-standing clinical practice guidelines for chronic stable angina from the of Cardiology and the American Heart Association. These treatment guidelines recommend that stable angina patients start with the best medical therapy and only receive angioplasty if their chest pain continues. What the study shows is how effective medication is for fairly low-risk patients who are in a stable condition.

Has anything changed?

"The study shows that patients have a choice -- they can delay stent implantation if medication and lifestyle changes provide satisfactory freedom from symptoms," said Freedman, who is also an emergency room physician. "It says that doctors must use medication aggressively and counsel low-risk patients about the trade-offs of the two therapies. And by reinforcing a proven treatment, it leaves room for health insurers to argue for controls over angioplasty as a purely preventive measure."

According to Freedman, the study results may prompt some hospitals to compare their practice patterns to ACC/AHA guidelines. Risk managers concerned about their hospital's utilization of angioplasty services might also consider external peer review to assess appropriateness of individual cases, and to identify any departures from evidence-based recommendations.

But Freedman doesn't think hospitals that have adhered to the ACC/AHA guidelines need to change what they do. Still, patients who experience angina pain despite medical therapy may elect to have angioplasty to reduce chest pain -- just as one third of the patients in the study did.

"It's unfortunate the press and public misunderstood the populations studied and simplified the study results, pitting angioplasty against medication," said Freedman. "Both are viable solutions for treating stable coronary disease. They are complementary, not competing, solutions."

For more information on making informed decisions on whether angioplasty and stenting is medically necessary, visit AllMed's web site at

CONTACT: Martin Middlewood, +1-360-882-1164, , forAllMed Healthcare Management

Web site:

Terms and conditions of use apply
Copyright © 2007 PR Newswire Association LLC. All rights reserved.
A United Business Media Company


Related medicine technology :

1. New Study Suggests Better Patient Outcomes with CYPHER Sirolimus-Eluting Coronary Stent than with Taxus Stent in Real-World Clinical Settings
2. Positive Results for Second-Generation Taxus Liberte Coronary Stent System Highlighted in Journal of American College of Cardiology
3. Efficacy of OrbusNeichs Genous Bio-Engineered R Stent Compares Favorably to Drug-Eluting Stents
4. Abbott Announces Positive Nine-Month Results From the Worlds First Clinical Trial of a Fully Bioabsorbable Drug Eluting Coronary Stent
5. Abbott Announces Continued Positive Results with Xience V Everolimus Eluting Coronary Stent in Spirit Clinical Trials
6. Investigators Report COSTAR II Pivotal Drug-Eluting Stent Trial Results at EuroPCR 2007
7. SPIRIT Clinical Data Reaffirm Strength of Taxus and Promus Drug-Eluting Coronary Stent Systems
8. Medtronic Announces Positive Nine-Month Results for Endeavor Resolute Next Generation Drug-Eluting Stent at EuroPCR
9. Taxus VI Clinical Trial Demonstrates Positive Long-Term Outcomes for Moderate-Release Paclitaxel-Eluting Stent at Four Years
10. ARRIVE Registry Analysis Identifies Predictors of Stent Thrombosis in Real-World Use of Drug-Eluting Stents
11. Cypher Sirolimus-Eluting Coronary Stent Had Similar Results to Bypass Surgery and Better Outcomes Than Bare Metal Stents in Subgroup Analysis of Diabetic Patients With Multivessel Coronary Disease
Post Your Comments:
(Date:6/24/2016)... , June 24, 2016 Dehaier Medical ... the "Company"), which develops, markets and sells medical devices ... , signed a strategic cooperation agreement with Hongyuan ... "Hongyuan Supply Chain") on June 20, 2016, to develop ... the strategic cooperation agreement, Dehaier will leverage Hongyuan Supply ...
(Date:6/24/2016)... Belgium , June 24, 2016 /PRNewswire/ ... announced the appointment of Dr. Edward Futcher ... a Non-Executive Director, effective June 23, 2016.Dr. Futcher ... and Nominations and Governance Committees.  As a non-executive ... provide independent expertise and strategic counsel to VolitionRx ...
(Date:6/23/2016)... 23, 2016 Research and Markets ... Market by Type (Organic Chemical (Sugar, Petrochemical, Glycerin), Inorganic ... Coating, Parenteral) - Global Forecast to 2021" report ... The global pharmaceutical excipients market is projected to ... of 6.1% in the forecast period 2016 to 2021. ...
Breaking Medicine Technology:
(Date:6/25/2016)... ... June 25, 2016 , ... On Friday, June 10, Van Mitchell, ... at Work award to iHire in recognition of their exemplary accomplishments in worksite health ... annual Maryland Workplace Health & Wellness Symposium at the BWI Marriott in Linthicum Heights. ...
(Date:6/24/2016)... ... June 24, 2016 , ... Those who have experienced traumatic ... many turn to unhealthy avenues, such as drug or alcohol abuse, as a coping ... released tools for healthy coping following a traumatic event. , Trauma sufferers tend to ...
(Date:6/24/2016)... ... June 24, 2016 , ... The Pulmonary ... Dallas that it will receive two significant new grants to support its work ... marked its 25th anniversary by recognizing patients, medical professionals and scientists for their ...
(Date:6/24/2016)... ... June 24, 2016 , ... Comfort Keepers® of San Diego, CA is ... Road To Recovery® program to drive cancer patients to and from their cancer treatments. ... the highest quality of life and ongoing independence. Getting to and from medical ...
(Date:6/24/2016)... ... June 24, 2016 , ... EB Medicine presented its first-ever ... Medicine conference in Ponte Vedra Beach, FL. The awards honor the outstanding work ... Practice and Pediatric Emergency Medicine Practice. , “With this award, we recognize ...
Breaking Medicine News(10 mins):