Drug therapy or coronary angioplasty for the treatment of coronary artery disease: new insights.
BACKGROUND
In the last decade percutaneous transluminal coronary angioplasty has become a very popular strategy for the treatment of coronary artery disease, although its efficacy in reducing ischemic events and the subsequent need for revascularization has yet to be proved.


METHODS
We reviewed the latest trials that compared percutaneous transluminal coronary angioplasty and medical therapy.


RESULTS
We discuss the potentially favorable effect of lipid-lowering therapy on coronary atherosclerosis and cardiac events and comment on the results of the recent Atorvastatin Versus Revascularization Treatments (AVERT) study that compared lipid-lowering treatment and percutaneous transluminal coronary angioplasty in patients with stable coronary artery disease.


CONCLUSIONS
Medical treatment aimed at reversing plaque growth and promoting plaque stabilization should probably be considered as the initial therapeutic option. Statin class drugs, together with aggressive management of known risk factors, show promise as the first step after appropriate early diagnosis. Revascularization procedures should subsequently be considered for all patients who do not respond to medical treatment or in whom the disease shows clear signs of progression.
Amoroso
G
G
University Hospital of Groningen, The Netherlands. G.Amoroso@thorax.azg.nl
Van Boven
A J
AJ
Crijns
H J
HJ
D015906:Angioplasty, Balloon, Coronary; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000175:diagnosis / Q000628:therapy*; D003657:Decision Making; D005343:Fibrinolytic Agents / Q000627:therapeutic use; D006801:Humans; D011379:Prognosis; D012720:Severity of Illness Index; D015912:Thrombolytic Therapy
D005343:Fibrinolytic Agents