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PCI May Not Improve Survival for Some Heart Disease Patients

Findings in patients with stable ischemic heart disease

THURSDAY, Nov. 12, 2015 (HealthDay News) — Patients with stable ischemic heart disease who undergo percutaneous coronary intervention (PCI) fare no better than those treated with medication and lifestyle changes alone, according to a report published in the Nov. 12 issue of the New England Journal of Medicine.

Researchers looked at the long-term survival of 1,211 patients who took part in the COURAGE trial (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation). In that trial, patients were randomly assigned to have PCI plus medication, or receive medical therapy alone to manage their stable ischemic heart disease and relieve their angina.

During the 15-year follow-up, 561 patients died: 180 died during the initial four-year follow-up period in the original trial, and 381 died during the remaining follow-up period. Among those who had undergone PCI, 284 patients died. And 277 died in the group treated with medical therapy alone, the researchers reported.

“Patients need to understand what they are getting an angioplasty for,” coauthor William Boden, M.D., a professor of medicine at Albany Medical College in New York, told HealthDay. “If they are being told that it’s going to reduce the risk of heart attack or it’s going make them live longer, they’re getting the wrong message.”

The study was funded in part by the pharmaceutical industry.

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