Coronary disease, stable, non-acute: Revascularization (percutaneous) versus optimal medical treatment alone
DISEASE INTERVENTION COMPARISON RESULTS
N Engl J Med. 2007 Apr 12;356(15):1503-16. Epub 2007 Mar 26 Randomized Controlled Trial, Multicenter Study
IN coronary disease, stable The Use of
routine invasive strategy (angiography and revascularization)
As Treatment, Chronic
Is equal Than
optimal medical therapy alone
To reduce all-cause mortality or myocardial infarction, at 4.6 years: 19% routine PCI vs. 18.5% medical Tt alone. No difference in stroke or hospitalizations neither.
JAMA. 2003 Mar 5;289(9):1117-23 Randomized Controlled Trial, Multicenter Study
IN coronary disease, stable angina, elderly patients The Use of
routine invasive strategy (angiography and revascularization)
As Treatment, Chronic
Is equal Than
optimal medical therapy alone
To modify 1-year mortality (11% invasive VS 8% medical, p NS) or modify death + nonfatal infarction (17% invasive VS 20% medical). Invasive approach had increased events early months, and medical management had more cardiac events after 6 months.
Circulation. 2007 Mar 6;115(9):1082-9 Randomized Controlled Trial, Multicenter Study
IN coronary disease, stable angina, multvessel disease The Use of
coronary artery bypass graft (CABG)
As Treatment, Chronic
Is better Than
naked percutaneous coronary intervention (PCI), or medical therapy alone
To reduce, at 5 years, myocardial infarction, or refractory angina requiring revascularization (21% CABG VS 33% PCI VS 36% medical). No differences in overall mortality between the 3 goups
N Engl J Med. 2009 Jun 11;360(24):2503-15. Epub 2009 Jun 7 Randomized Controlled Trial, Multicenter Study
IN coronary disease, stable, diabetes mellitus, type 2 The Use of
systematic prompt revascularization, either by percutaneous coronary intervention (PCI) or coronary-artery bypass grafting (CABG)
As Treatment, Chronic
Is equal Than
intensified medical therapy alone
To reduce at 5 years major cardiovascular events (77.2% revascularization VS 75.9% medical Tt). A reduction in cardiovascular events was observed with CABG in tri-troncular patients (22% revascularization VS 30% medical Tt)