MedStar Authors catalog › Details for: A meta-analysis of optimal medical therapy with or without percutaneous coronary intervention in patients with stable coronary artery disease.
Normal view MARC view ISBD view

A meta-analysis of optimal medical therapy with or without percutaneous coronary intervention in patients with stable coronary artery disease.

by Weintraub, William S.
Citation: Coronary Artery Disease. 33(2):91-97, 2022 03 01.; .Journal: Coronary artery disease.Published: 2022; ; ; ISSN: 0954-6928.Full author list: Boden WE; Davis DA; Labroo A; Le FK; Nasr A; Nayyar M; Rashid A; Shah R; Weintraub WS.UI/PMID: 33878073.Subject(s): *Coronary Artery Disease/th [Therapy] | *Percutaneous Coronary Intervention/st [Standards] | Cardiovascular Agents/ae [Adverse Effects] | Cardiovascular Agents/pd [Pharmacology] | Coronary Artery Disease/co [Complications] | Humans | Percutaneous Coronary Intervention/mt [Methods] | Treatment OutcomeInstitution(s): MedStar Heart & Vascular InstituteActivity type: Journal Article.Medline article type(s): Journal ArticleDigital Object Identifier: https://dx.doi.org/10.1097/MCA.0000000000001041https://dx.doi.org/10.1097/MCA.0000000000001041xl - https://dx.doi.org/10.1097/MCA.0000000000001041 (Click here) | (Click here) Abbreviated citation: Coron Artery Dis. 33(2):91-97, 2022 03 01; .Abstract: BACKGROUND: Whether percutaneous coronary intervention (PCI) improves clinical outcomes in patients with chronic angina and stable coronary artery disease (CAD) has been a continuing area of investigation for more than two decades. The recently reported results of the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches, the largest prospective trial of optimal medical therapy (OMT) with or without myocardial revascularization, provides a unique opportunity to determine whether there is an incremental benefit of revascularization in stable CAD patients.Abstract: CONCLUSIONS: In patient with chronic stable CAD (without left main disease or reduced ejection fraction), PCI in addition to OMT did not improve mortality or MI compared to OMT alone. However, this strategy is associated with a lower rate of revascularization and improved anginal symptoms. Copyright (c) 2021 Wolters Kluwer Health, Inc. All rights reserved.Abstract: METHODS: Scientific databases and websites were searched to find randomized clinical trials (RCTs). Pooled risk ratios were calculated using the random-effects model.Abstract: RESULTS: Data from 10 RCTs comprising 12 125 patients showed that PCI, when added to OMT, were not associated with lower all-cause mortality (risk ratios, 0.96; 95% CI, 0.87-1.08), cardiovascular mortality (risk ratios, 0.91; 95% CI, 0.79-1.05) or myocardial infarction (MI) (risk ratios, 0.90; 95% CI, 0.78-1.04) as compared with OMT alone. However, OMT+PCI was associated with improved anginal symptoms and a lower risk for revascularization (risk ratios, 0.52; 95% CI, 0.37-0.75).

Powered by Koha