Results of a new study show that patients with stable heart disease have comparable outcomes whether they have angioplasty or receive aggressive drug therapy. Physicians previously held the belief that treatment for these patients had to be either angioplasty or heart bypass surgery. The trial, known as Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE), included almost 2300 randomly assigned patients with stable but significant heart disease. Group 1 received drug therapy alone, while group 2 received drug therapy plus angioplasty; in the latter group, 94% of patients received at least 1 stent. The follow-up, which lasted from 2 to 7 years, showed that 19% of patients in the angioplasty group either died or had a heart attack, compared with 18.5% of the drug treatment group. Researchers also found little statistical difference between the 2 groups when comparing rates of death, heart attack, stroke, or hospitalization for acute coronary syndrome or heart attack alone. The primary benefit of angioplasty over drug therapy, according to the researchers, is that it reduced chest pains over the long term.Ms. Farley is a freelance medical writer based in Wakefield, RI.
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