No Benefit for Stent Versus Medical Therapy in Stable CAD
March 01, 2012
Kathleen Stergiopoulos, M.D., Ph.D., and David L. Brown, M.D., of the Stony Brook University Medical Center in New York, conducted a meta-analysis of eight prospective randomized clinical trials identified from the literature and involving 7,229 patients who underwent either initial coronary stent implantation or medical therapy for treatment of stable CAD. The effect of each intervention on the mortality rate and incidence of nonfatal myocardial infarction, unplanned revascularization, and persistent angina was investigated.
The researchers found that the respective event rates for death after an average 4.3-year follow-up period were 8.9 percent with stent implantation and 9.1 percent with medical therapy (odds ratio [OR], 0.98; 95 percent confidence interval [CI], 0.84 to 1.16). The incidence of nonfatal myocardial infarction was 8.9 and 8.1 percent for stent implantation and medical therapy, respectively (OR 1.12; 95 percent CI, 0.93 to 1.34). Rates of unplanned revascularization (21 and 34 percent, respectively; OR, 0.78; 95 percent CI, 0.57 to 1.06) and persistent angina (29 and 33 percent, respectively; OR, 0.80; 95 percent CI, 0.60 to 1.05) were also similar between the two intervention groups.
"Initial stent implantation for stable CAD shows no evidence of benefit compared with initial medical therapy for prevention of death, nonfatal myocardial infarction, unplanned revascularization, or angina," the authors write.
A 6-year study of people with type 2 diabetes shows that intensively lowering blood pressure has a long-lasting effect in preventing heart attacks, strokes, and deaths, but intensive blood glucose control does not. The findings were published online Sept. 19 in the New England Journal of Medicine to coincide with presentation of the findings at the annual meeting of the European Association for the Study of Diabetes in Vienna.
Consumers are more likely to buy high-calorie foods (HCF), but not low-calorie foods (LCF) on sale, according to a study published in the US Center for Disease Control and Prevention's Preventing Chronic Disease.
Systemwide changes are necessary to prevent excessive healthcare spending, and so are tools to help consumers make better, more informed medical choices, according to a white paper published in June by Vitals.
Magnetic resonance is an effective alternative to biopsy for identifying and quantifying fats in the liver, according to results from a study led by a research team at the University of the Basque Country.
The US Centers for Disease Control and Prevention have released a Category A recommendation for revised routine pneumococcal vaccination in older adults. The recommendation has been published in the Sept. 19 issue of the CDC's Morbidity and Mortality Weekly Report.