Coronary arterial revascularization: past, present, future: part I--historical trials.
Advances in coronary artery revascularization have been accompanied by clinical trials evaluating these advances. From the Coronary Artery Surgery Study and Bypass Angioplasty Revascularization Investigation to the more recent Arterial Revascularization Therapy Study (ARTS1) and the Medicine, Angioplasty, or Surgery Study (MASS2), these clinical trials provide us with a rationale for the way we conduct clinical practice. This paper reviews the data supporting historical revascularization strategies for our patients, including medical therapy, angioplasty, and bare metal stents. Several recurrent themes emerge. These include a need for increased revascularization in patients who undergo percutaneous treatments, the durability of surgical arterial revascularization, and the importance of medical therapy as the mainstay of treatment. Part II will address newer therapies.
Gupta
Anuj
A
Division of Cardiology, Department of Medicine, Temple University Hospital, Philadelphia, PA 19140, USA. anuj@bellatlantic.net
Burke
James
J
Bove
Alfred
A
D015906:Angioplasty, Balloon, Coronary; D006328:Cardiac Catheterization / Q000266:history; D001026:Coronary Artery Bypass / Q000266:history; D003327:Coronary Disease / Q000188:drug therapy / Q000601:surgery*; D005544:Forecasting; D049673:History, 20th Century; D006801:Humans; D011788:Quality of Life; D016032:Randomized Controlled Trials as Topic; D015607:Stents