Optimal Medical Therapy with or without PCI for Stable Coronary Disease
In a randomized trial, 2287 patients with coronary artery disease and evidence of ischemia were assigned to receive optimal medical therapy with or without percutaneous coronary intervention (PCI). At a median of 4.6 years, the rates of death and myocardial infarction were 19.0% in the PCI group and...
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| Veröffentlicht in: | The New England journal of medicine 2007-04, Vol.356 (15), p.1503-1516 |
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| container_title | The New England journal of medicine |
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| creator | Boden, William E O'Rourke, Robert A Teo, Koon K Hartigan, Pamela M Maron, David J Kostuk, William J Knudtson, Merril Dada, Marcin Casperson, Paul Harris, Crystal L Chaitman, Bernard R Shaw, Leslee Gosselin, Gilbert Nawaz, Shah Title, Lawrence M Gau, Gerald Blaustein, Alvin S Booth, David C Bates, Eric R Spertus, John A Berman, Daniel S Mancini, G.B. John Weintraub, William S |
| description | In a randomized trial, 2287 patients with coronary artery disease and evidence of ischemia were assigned to receive optimal medical therapy with or without percutaneous coronary intervention (PCI). At a median of 4.6 years, the rates of death and myocardial infarction were 19.0% in the PCI group and 18.5% in the medical-therapy group. The PCI group had lower rates of angina and repeat revascularization.
Patients with coronary artery disease and evidence of ischemia were assigned to receive optimal medical therapy with or without percutaneous coronary intervention (PCI). At a median of 4.6 years, the rates of death and myocardial infarction were 19.0% in the PCI group and 18.5% in the medical-therapy group.
During the past 30 years, the use of percutaneous coronary intervention (PCI) has become common in the initial management strategy for patients with stable coronary artery disease in North America, even though treatment guidelines advocate an initial approach with intensive medical therapy, a reduction of risk factors, and lifestyle intervention (known as optimal medical therapy).
1
,
2
In 2004, more than 1 million coronary stent procedures were performed in the United States,
3
and recent registry data indicate that approximately 85% of all PCI procedures are undertaken electively in patients with stable coronary artery disease.
4
PCI reduces the incidence of death and . . . |
| doi_str_mv | 10.1056/NEJMoa070829 |
| format | Article |
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Patients with coronary artery disease and evidence of ischemia were assigned to receive optimal medical therapy with or without percutaneous coronary intervention (PCI). At a median of 4.6 years, the rates of death and myocardial infarction were 19.0% in the PCI group and 18.5% in the medical-therapy group.
During the past 30 years, the use of percutaneous coronary intervention (PCI) has become common in the initial management strategy for patients with stable coronary artery disease in North America, even though treatment guidelines advocate an initial approach with intensive medical therapy, a reduction of risk factors, and lifestyle intervention (known as optimal medical therapy).
1
,
2
In 2004, more than 1 million coronary stent procedures were performed in the United States,
3
and recent registry data indicate that approximately 85% of all PCI procedures are undertaken electively in patients with stable coronary artery disease.
4
PCI reduces the incidence of death and . . .</description><identifier>ISSN: 0028-4793</identifier><identifier>EISSN: 1533-4406</identifier><identifier>DOI: 10.1056/NEJMoa070829</identifier><identifier>PMID: 17387127</identifier><identifier>CODEN: NEJMAG</identifier><language>eng</language><publisher>Boston, MA: Massachusetts Medical Society</publisher><subject>Adrenergic beta-Antagonists - therapeutic use ; Aged ; Angina Pectoris - therapy ; Angioplasty, Balloon, Coronary ; Angiotensin-Converting Enzyme Inhibitors - therapeutic use ; Anticholesteremic Agents - therapeutic use ; Antihypertensive Agents - therapeutic use ; Biological and medical sciences ; Cardiology. Vascular system ; Combined Modality Therapy ; Coronary Disease - drug therapy ; Coronary Disease - mortality ; Coronary Disease - therapy ; Coronary heart disease ; Drug Therapy, Combination ; Female ; General aspects ; Heart ; Humans ; Kaplan-Meier Estimate ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - epidemiology ; Myocardial Infarction - prevention & control ; Platelet Aggregation Inhibitors - therapeutic use ; Proportional Hazards Models ; Risk Factors ; Stroke - epidemiology</subject><ispartof>The New England journal of medicine, 2007-04, Vol.356 (15), p.1503-1516</ispartof><rights>Copyright © 2007 Massachusetts Medical Society. All rights reserved.</rights><rights>2007 INIST-CNRS</rights><rights>Copyright 2007 Massachusetts Medical Society.</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c547t-3f6509c5e4191047f942289a9887fcfb4ccbe6e9fb385991c3cb463cc25062d53</citedby><cites>FETCH-LOGICAL-c547t-3f6509c5e4191047f942289a9887fcfb4ccbe6e9fb385991c3cb463cc25062d53</cites></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><linktopdf>$$Uhttps://www.nejm.org/doi/pdf/10.1056/NEJMoa070829$$EPDF$$P50$$Gmms$$H</linktopdf><linktohtml>$$Uhttps://www.proquest.com/docview/223922293?pq-origsite=primo$$EHTML$$P50$$Gproquest$$H</linktohtml><link.rule.ids>315,782,786,2763,2764,26112,27933,27934,52391,54073,64394,64396,64398,72478</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=18665123$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/17387127$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Boden, William E</creatorcontrib><creatorcontrib>O'Rourke, Robert A</creatorcontrib><creatorcontrib>Teo, Koon K</creatorcontrib><creatorcontrib>Hartigan, Pamela M</creatorcontrib><creatorcontrib>Maron, David J</creatorcontrib><creatorcontrib>Kostuk, William J</creatorcontrib><creatorcontrib>Knudtson, Merril</creatorcontrib><creatorcontrib>Dada, Marcin</creatorcontrib><creatorcontrib>Casperson, Paul</creatorcontrib><creatorcontrib>Harris, Crystal L</creatorcontrib><creatorcontrib>Chaitman, Bernard R</creatorcontrib><creatorcontrib>Shaw, Leslee</creatorcontrib><creatorcontrib>Gosselin, Gilbert</creatorcontrib><creatorcontrib>Nawaz, Shah</creatorcontrib><creatorcontrib>Title, Lawrence M</creatorcontrib><creatorcontrib>Gau, Gerald</creatorcontrib><creatorcontrib>Blaustein, Alvin S</creatorcontrib><creatorcontrib>Booth, David C</creatorcontrib><creatorcontrib>Bates, Eric R</creatorcontrib><creatorcontrib>Spertus, John A</creatorcontrib><creatorcontrib>Berman, Daniel S</creatorcontrib><creatorcontrib>Mancini, G.B. John</creatorcontrib><creatorcontrib>Weintraub, William S</creatorcontrib><creatorcontrib>COURAGE Trial Research Group</creatorcontrib><title>Optimal Medical Therapy with or without PCI for Stable Coronary Disease</title><title>The New England journal of medicine</title><addtitle>N Engl J Med</addtitle><description>In a randomized trial, 2287 patients with coronary artery disease and evidence of ischemia were assigned to receive optimal medical therapy with or without percutaneous coronary intervention (PCI). At a median of 4.6 years, the rates of death and myocardial infarction were 19.0% in the PCI group and 18.5% in the medical-therapy group. The PCI group had lower rates of angina and repeat revascularization.
Patients with coronary artery disease and evidence of ischemia were assigned to receive optimal medical therapy with or without percutaneous coronary intervention (PCI). At a median of 4.6 years, the rates of death and myocardial infarction were 19.0% in the PCI group and 18.5% in the medical-therapy group.
During the past 30 years, the use of percutaneous coronary intervention (PCI) has become common in the initial management strategy for patients with stable coronary artery disease in North America, even though treatment guidelines advocate an initial approach with intensive medical therapy, a reduction of risk factors, and lifestyle intervention (known as optimal medical therapy).
1
,
2
In 2004, more than 1 million coronary stent procedures were performed in the United States,
3
and recent registry data indicate that approximately 85% of all PCI procedures are undertaken electively in patients with stable coronary artery disease.
4
PCI reduces the incidence of death and . . .</description><subject>Adrenergic beta-Antagonists - therapeutic use</subject><subject>Aged</subject><subject>Angina Pectoris - therapy</subject><subject>Angioplasty, Balloon, Coronary</subject><subject>Angiotensin-Converting Enzyme Inhibitors - therapeutic use</subject><subject>Anticholesteremic Agents - therapeutic use</subject><subject>Antihypertensive Agents - therapeutic use</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Combined Modality Therapy</subject><subject>Coronary Disease - drug therapy</subject><subject>Coronary Disease - mortality</subject><subject>Coronary Disease - therapy</subject><subject>Coronary heart disease</subject><subject>Drug Therapy, Combination</subject><subject>Female</subject><subject>General aspects</subject><subject>Heart</subject><subject>Humans</subject><subject>Kaplan-Meier Estimate</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - epidemiology</subject><subject>Myocardial Infarction - prevention & control</subject><subject>Platelet Aggregation Inhibitors - therapeutic use</subject><subject>Proportional Hazards Models</subject><subject>Risk Factors</subject><subject>Stroke - epidemiology</subject><issn>0028-4793</issn><issn>1533-4406</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2007</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><sourceid>ABUWG</sourceid><sourceid>AFKRA</sourceid><sourceid>AZQEC</sourceid><sourceid>BEC</sourceid><sourceid>BENPR</sourceid><sourceid>CCPQU</sourceid><sourceid>DWQXO</sourceid><sourceid>GNUQQ</sourceid><sourceid>GUQSH</sourceid><sourceid>M2O</sourceid><recordid>eNpt0EtLxDAUBeAgio6PnWspoq6s5tkkS6lvZlRwXJc0k2CHtqlJi8y_NzoDI2I2h8DHvZcDwCGCFwiy7PLp5nHiFORQYLkBRogRklIKs00wghCLlHJJdsBuCHMYH6JyG-wgTgRHmI_A3XPXV42qk4mZVTrm9N141S2Sz6p_T5z_STf0yUv-kNj4f-1VWZskd961yi-S6yoYFcw-2LKqDuZglXvg7fZmmt-n4-e7h_xqnGpGeZ8SmzEoNTMUSQQpt5JiLKSSQnCrbUm1Lk1mpC2JYFIiTXRJM6I1ZjDDM0b2wNlybufdx2BCXzRV0KauVWvcEAoOiYCQ4wiP_8C5G3wbbyswJhJjLElE50ukvQvBG1t0PrbhFwWCxXe7xe92Iz9azRzKxszWeFVnBKcroEIs03rV6iqsncgyhvD33pOla5pQtGbe_L_vC6ySivc</recordid><startdate>20070412</startdate><enddate>20070412</enddate><creator>Boden, William E</creator><creator>O'Rourke, Robert A</creator><creator>Teo, Koon K</creator><creator>Hartigan, Pamela M</creator><creator>Maron, David J</creator><creator>Kostuk, William J</creator><creator>Knudtson, Merril</creator><creator>Dada, Marcin</creator><creator>Casperson, Paul</creator><creator>Harris, Crystal L</creator><creator>Chaitman, Bernard R</creator><creator>Shaw, Leslee</creator><creator>Gosselin, Gilbert</creator><creator>Nawaz, Shah</creator><creator>Title, Lawrence M</creator><creator>Gau, Gerald</creator><creator>Blaustein, Alvin S</creator><creator>Booth, David C</creator><creator>Bates, Eric R</creator><creator>Spertus, John A</creator><creator>Berman, Daniel S</creator><creator>Mancini, G.B. 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Vascular system</topic><topic>Combined Modality Therapy</topic><topic>Coronary Disease - drug therapy</topic><topic>Coronary Disease - mortality</topic><topic>Coronary Disease - therapy</topic><topic>Coronary heart disease</topic><topic>Drug Therapy, Combination</topic><topic>Female</topic><topic>General aspects</topic><topic>Heart</topic><topic>Humans</topic><topic>Kaplan-Meier Estimate</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - epidemiology</topic><topic>Myocardial Infarction - prevention & control</topic><topic>Platelet Aggregation Inhibitors - therapeutic use</topic><topic>Proportional Hazards Models</topic><topic>Risk Factors</topic><topic>Stroke - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Boden, William E</creatorcontrib><creatorcontrib>O'Rourke, Robert A</creatorcontrib><creatorcontrib>Teo, Koon K</creatorcontrib><creatorcontrib>Hartigan, Pamela M</creatorcontrib><creatorcontrib>Maron, David J</creatorcontrib><creatorcontrib>Kostuk, William J</creatorcontrib><creatorcontrib>Knudtson, Merril</creatorcontrib><creatorcontrib>Dada, Marcin</creatorcontrib><creatorcontrib>Casperson, Paul</creatorcontrib><creatorcontrib>Harris, Crystal L</creatorcontrib><creatorcontrib>Chaitman, Bernard R</creatorcontrib><creatorcontrib>Shaw, Leslee</creatorcontrib><creatorcontrib>Gosselin, Gilbert</creatorcontrib><creatorcontrib>Nawaz, Shah</creatorcontrib><creatorcontrib>Title, Lawrence M</creatorcontrib><creatorcontrib>Gau, Gerald</creatorcontrib><creatorcontrib>Blaustein, Alvin S</creatorcontrib><creatorcontrib>Booth, David C</creatorcontrib><creatorcontrib>Bates, Eric R</creatorcontrib><creatorcontrib>Spertus, John A</creatorcontrib><creatorcontrib>Berman, Daniel S</creatorcontrib><creatorcontrib>Mancini, G.B. 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John</au><au>Weintraub, William S</au><aucorp>COURAGE Trial Research Group</aucorp><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Optimal Medical Therapy with or without PCI for Stable Coronary Disease</atitle><jtitle>The New England journal of medicine</jtitle><addtitle>N Engl J Med</addtitle><date>2007-04-12</date><risdate>2007</risdate><volume>356</volume><issue>15</issue><spage>1503</spage><epage>1516</epage><pages>1503-1516</pages><issn>0028-4793</issn><eissn>1533-4406</eissn><coden>NEJMAG</coden><abstract>In a randomized trial, 2287 patients with coronary artery disease and evidence of ischemia were assigned to receive optimal medical therapy with or without percutaneous coronary intervention (PCI). At a median of 4.6 years, the rates of death and myocardial infarction were 19.0% in the PCI group and 18.5% in the medical-therapy group. The PCI group had lower rates of angina and repeat revascularization.
Patients with coronary artery disease and evidence of ischemia were assigned to receive optimal medical therapy with or without percutaneous coronary intervention (PCI). At a median of 4.6 years, the rates of death and myocardial infarction were 19.0% in the PCI group and 18.5% in the medical-therapy group.
During the past 30 years, the use of percutaneous coronary intervention (PCI) has become common in the initial management strategy for patients with stable coronary artery disease in North America, even though treatment guidelines advocate an initial approach with intensive medical therapy, a reduction of risk factors, and lifestyle intervention (known as optimal medical therapy).
1
,
2
In 2004, more than 1 million coronary stent procedures were performed in the United States,
3
and recent registry data indicate that approximately 85% of all PCI procedures are undertaken electively in patients with stable coronary artery disease.
4
PCI reduces the incidence of death and . . .</abstract><cop>Boston, MA</cop><pub>Massachusetts Medical Society</pub><pmid>17387127</pmid><doi>10.1056/NEJMoa070829</doi><tpages>14</tpages><oa>free_for_read</oa></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0028-4793 |
| ispartof | The New England journal of medicine, 2007-04, Vol.356 (15), p.1503-1516 |
| issn | 0028-4793 1533-4406 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_70380072 |
| source | MEDLINE; Elektronische Zeitschriftenbibliothek - Frei zugängliche E-Journals; ProQuest Central UK/Ireland; New England Journal of Medicine |
| subjects | Adrenergic beta-Antagonists - therapeutic use Aged Angina Pectoris - therapy Angioplasty, Balloon, Coronary Angiotensin-Converting Enzyme Inhibitors - therapeutic use Anticholesteremic Agents - therapeutic use Antihypertensive Agents - therapeutic use Biological and medical sciences Cardiology. Vascular system Combined Modality Therapy Coronary Disease - drug therapy Coronary Disease - mortality Coronary Disease - therapy Coronary heart disease Drug Therapy, Combination Female General aspects Heart Humans Kaplan-Meier Estimate Male Medical sciences Middle Aged Myocardial Infarction - epidemiology Myocardial Infarction - prevention & control Platelet Aggregation Inhibitors - therapeutic use Proportional Hazards Models Risk Factors Stroke - epidemiology |
| title | Optimal Medical Therapy with or without PCI for Stable Coronary Disease |
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