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PCI shows no mortality benefit in stress positive CAD

Reuters Health • The Doctor's Channel Daily Newscast

NEW YORK (Reuters Health) – Coronary artery stenting does not reduce long-term rates of myocardial infarction (MI) or mortality in patients with stress-positive stable coronary artery disease, German researchers report in an April 12th online paper in the American Journal of Cardiology.

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.

Reference:

Am J Cardiol 2010.