Medications as effective as stents for most with coronary artery disease

This study suggests that for most, managing CAD with medications alone (the conservative approach) is as safe and effective as the more invasive strategy of cardiac catheterization and opening of the blocked artery. Findings of the ISCHEMIA trial ISCHEMIA followed over 5,000 patients with significant narrowing in one or more coronary arteries. Half of the patients were randomly selected to receive conservative treatment with optimal medical therapy (OMT) and lifestyle changes to treat risk factors such as high blood pressure and high cholesterol. The other half were given OMT and also sent for cardiac catheterization (threading of a flexible catheter into the heart arteries to look for narrowed or blocked coronary blood vessels). When blockages were found, these patients underwent placement of a small mesh tube, called a stent, to prop open the affected area. When blockages were too complex for stent placement, open-heart surgery was performed. The findings were surprising. Many cardiologists would have predicted that the invasive strategy would be superior to the conservative strategy. The group that received stents did report greater relief of angina, or chest pain. But there was no significant difference between the two groups in terms of rates of heart attack, death, or hospitalization for worsening heart pain. Proponents of the conservative approach argue that OMT makes more sense than stenting because it addresses all the arteries in the heart, not just the small sectio...
Source: Harvard Health Blog - Category: Consumer Health News Authors: Tags: Health Source Type: blogs