Evidence Summary
What is an Evidence Summary?
Key messages from scientific research that's ready to be acted on
Got It, Hide thisIn people with coronary heart disease and ischemia, adding angioplasty to drug treatment does not reduce cardiovascular events
Stergiopoulos K, Boden WE, Hartigan P, et al. Percutaneous coronary intervention outcomes in patients with stable obstructive coronary artery disease and myocardial ischemia: a collaborative meta-analysis of contemporary randomized clinical trials. JAMA Intern Med. 2014;174:232-40.
Review question
In people who have stable coronary heart disease and myocardial ischemia, does percutaneous coronary intervention ( also known as angioplasty or PCI) in addition to drug treatment reduce death or cardiovascular events compared with drug treatment alone?
Background
People who have coronary heart disease are usually treated with drugs. People who also have myocardial ischemia are more likely to have a heart attack or die. They may be treated with coronary revascularization in addition to drugs.
How the review was done
The researchers did a systematic review, searching for published studies up to November 2012. They found 5 randomized controlled trials with 4064 people, mostly men (average age 59 to 64 years).
People in the studies had stable coronary heart disease and myocardial ischemia. People who had just had a myocardial infarction (heart attack) were not included.
Percutaneous coronary intervention (angioplasty) plus drug treatment was compared with drug treatment alone. Drug treatment could include as aspirin, beta-blockers, angiotensin-converting enzyme inhibitors, angiotensin-receptor blockers, or statins
What the researchers found
Compared with drug treatment alone, percutaneous coronary intervention plus drug treatment did not reduce death, myocardial infarction (heart attack), angina (chest pain), or emergency coronary revascularization at about 5 years.
Conclusion
In people with stable coronary heart disease and myocardial ischemia, adding percutaneous coronary intervention to drug treatment did not reduce death or other cardiovascular outcomes more than drug treatment alone at about 5 years of follow-up.
Percutaneous coronary intervention (angioplasty) plus drug treatment vs drug treatment alone in people with coronary artery disease and myocardial ischemia*
| Outcomes at about 5 years | Angioplasty + drug treatment | Drug treatment alone |
| Death | 6.6% | 7.3% |
| Myocardial infarction (heart attack) | 20% | 28% |
| Angina (chest pain) | 22% | 23% |
| Emergency coronary revascularization | 9.3% | 7.6% |
Related Topics
Glossary
Chest pain due to reduced blood flow to the heart.
A group of medications that control the hormone system that regulates blood pressure and water balance in the body.
A group of medications that block the chemicals that tighten the muscles around blood vessels. As a result, blood vessels enlarge and blood pressure is reduced.
Medications that slow down the heartbeat, decrease the force of the contractions of the heart muscles, and reduce blood vessel contraction in the heart, brain, as well as the rest of the body.
Also known as coronary artery disease (CAD), is a narrowing of the blood vessels (coronary arteries) that supply oxygen and blood to the heart.
A procedure to restore the blood supply to the heart. Common types are coronary artery bypass graft surgery (or bypass surgery) and percuntaneous coronary intervention (or angioplasty).
Studies where people are assigned to one of the treatments purely by chance.
A comprehensive evaluation of the available research evidence on a particular topic.
The body's network of blood vessels. It includes the arteries, veins, and capillaries that carry blood to and from the heart.
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