Dr. Rainer Hoffmann of University RWTH Aachen and colleagues studied data on more than a thousand patients with at least 50% coronary artery stenosis and positive findings on single-photon emission computed tomography.
Ultimately, the researchers compared 266 patients who received coronary artery stents with a group of 266 matched controls who received medical treatment.
Over a mean follow-up of 6.4 years, there were no significant differences with stenting vs medical treatment in mortality (13.5% vs 10.9%) or in the incidence of MI (5.3 vs 5.6%).
Less than a year from baseline, the rate of revascularization was significantly higher in the stent group (14.7% vs 6.0%). Beyond one year, however, revascularization rates in the two groups were similar.
At the end of follow-up, significantly fewer patients with stents complained of angina pectoris (38 versus 49%). The medically managed patients also had a higher rate of nitrate use.
The researchers stress that the study was a retrospective matching analysis, with no data on clinical symptoms during the complete follow-up period.
Nevertheless, they conclude that while stent implantation did not reduce mortality or non-fatal MI, it did reduce complaints of angina pectoris.
The authors also point out that all patients in this study received bare-metal stents. “In the current era of drug-eluting stents, follow-up event rates may be different,” they added.
Am J Cardiol 2010.