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 http://www.allmedmd.com.

CONTACT: Martin Middlewood, +1-360-882-1164, , forAllMed Healthcare Management martinm@pacifier.com

Web site: http://www.allmedmd.com//

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:
*Name:
*Comment:
*Email:
(Date:6/23/2016)... 2016  MedSource announced today that it has ... solution of choice.  This latest decision demonstrates MedSource,s ... their clients by offering a state-of-the-art electronic data ... nowEDC as the EDC platform of choice in ... "nowEDC has long been a preferred EDC platform ...
(Date:6/23/2016)... , June 23, 2016 Any dentist who has ... of the current process. Many of them do not even ... technical difficulties and high laboratory costs involved. And those who ... it at such a high cost that the majority of ... Dr. Parsa Zadeh , founder of Dental Evolutions ...
(Date:6/23/2016)...  In a startling report released today, National Safety Council ... a comprehensive, proven plan to eliminate prescription opioid overdoses. ... states are tackling the worst drug crisis in recorded U.S. history, ... Kentucky , New Mexico , ... the 28 failing states, three – Michigan , ...
Breaking Medicine Technology:
(Date:6/24/2016)... ... ... in a crisis. Her son James, eight, was out of control. Prone to extreme mood ... something upset him, he couldn’t control his emotions,” remembers Marcy. “If there was a ... children and say he was going to kill them. If we were driving on ...
(Date:6/24/2016)... ... June 24, 2016 , ... Global law firm Greenberg Traurig, P.A. ... The attorneys chosen by their peers for this recognition are considered among the top ... Shareholders received special honors as members of this year’s Legal Elite Hall of Fame: ...
(Date:6/24/2016)... CA (PRWEB) , ... June 24, 2016 , ... Comfort ... the American Cancer Society and the Road To Recovery® program to drive cancer patients ... seniors and other adults to ensure the highest quality of life and ongoing independence. ...
(Date:6/24/2016)... , ... June 24, 2016 , ... People across the ... Genome magazine’s Code Talker Award, an essay contest in which patients and their families ... to be presented at the 2016 National Society of Genetic Counselors (NSGC) Annual Education ...
(Date:6/24/2016)... (PRWEB) , ... June 24, 2016 , ... ... Living, is proud to recognize Dr. Barry M. Weintraub as a prominent plastic ... most beautiful women in the world, and the most handsome men, look naturally ...
Breaking Medicine News(10 mins):