Combined Therapy Improves Coronary Artery Disease Outcome

THURSDAY, Oct. 23 (HealthDay News) -- In patients with stable low-risk coronary artery disease, the addition of percutaneous coronary intervention (PCI) to medical therapy does not lower the risk of death but does lower the cumulative risk of death plus other adverse outcomes, according to a study published in the October issue of the Journal of the American College of Cardiology: Cardiovascular Interventions.

Kazuhiko Nishigaki, M.D., Ph.D., and colleagues from Gifu University Graduate School of Medicine in Gifu City, Japan, randomly assigned 384 patients with low-risk stable coronary artery disease to initial medical therapy alone or combined with PCI.

During the 3.3-year follow-up, the researchers found that medical therapy plus PCI or medical therapy alone resulted in similar cumulative death rates (2.9 versus 3.9 percent, respectively, hazard ratio 0.865). However, the medical therapy plus PCI group had a significantly lower cumulative risk of death plus acute coronary syndrome (HR, 0.474), of death, acute coronary syndrome and cerebrovascular accidents (HR, 0.541), and of death, acute coronary syndrome, cerebrovascular accidents and hospitalization (HR, 0.664).

"The use of PCI is very effective and superior to medical therapy for reducing or abolishing angina and improving functional status," Abhiram Prasad, M.D., and Bernard J. Gersh, from the Mayo Clinic in Rochester, Minn., write in an accompanying editorial. "However, revascularization must be considered an adjunct, rather than an alternative, to optimal medical therapy."

Gersh discloses financial relationships with the pharmaceutical industry.

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