Heart intervention doesn't outweigh medicine in study

LEXINGTON, Ky. (March 27, 2007) -- In what some leading cardiologists are calling a "blockbuster" study, new research could alter the approach to treating patients who have cardiovascular disease but may not be at immediate risk of heart attack or stroke.

Co-authored by UK HealthCare's Linda and Jack Gill Heart Institute cardiologist Dr. David Booth, results of a five-year study released today showed that stable heart patients received no significant benefit in undergoing angioplasty when compared to patients treated with medication alone. The study, Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial, is published in the current issue of the New England Journal of Medicine and was presented this morning at the American College of Cardiologys annual scientific sessions in New Orleans.

More than 2,000 patients at 50 sites in North America, including the Lexington VA Medical Center at the University of Kentucky, were followed for four and a half years. The rate of death, heart attack and stroke was 19.5 percent in patients who had medication alone and 20 percent in patients who had percutaneous cardiac intervention, or PCI (procedures that involve clearing blocked vessels by inserting a catheter into a blood vessel, usually in the groin or arm, allowing the physician to access the blockage). While the study did show that patients who underwent PCI had the most relief from symptoms of angina, or mild chest pain that usually occurs with exertion and is relieved with rest and medication, patients who received medication alone also showed significant improvement in symptoms.

The study indicates that intervention can be safely deferred in stable heart patients, who in most cases may be treated initially with medication to lower cholesterol and prevent heart attack.

"The purpose of treating patients is to make them feel better, live longer, or both. For patients with stable, and I emphasize

Contact: Beth Goins
University of Kentucky

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