Percutaneous coronary intervention plus medical therapy reduces the incidence of acute coronary syndrome more effectively than initial medical therapy only among patients with low-risk coronary artery disease a randomized, comparative, multicenter study.
OBJECTIVE
This study sought to determine whether initial medical therapy (MT) only or percutaneous coronary intervention plus medical therapy (PCI+MT) is better for patients with low-risk stable coronary artery disease (CAD) indicated for intervention in Japan.


BACKGROUND
Several multicenter studies have suggested that in the above patients, an initial management strategy of PCI+MT does not reduce the long-term risk of cardiovascular events more effectively than initial MT only.


METHODS
We conducted a randomized comparative study (JSAP [Japanese Stable Angina Pectoris] study) in the previously mentioned patients.


RESULTS
The patients were randomized to PCI+MT (n = 192) or initial MT only group (n = 192), and the patient characteristics were very similar in the 2 groups. During the 3.3-year follow-up, there was no significant difference in the cumulative death rate between PCI+MT (2.9%) and MT (3.9%). However, the cumulative risk of death plus acute coronary syndrome was significantly smaller in PCI+MT.


CONCLUSIONS
In stable low-risk CAD, PCI+MT may improve long-term prognosis more effectively than MT.
Nishigaki
Kazuhiko
K
Second Department of Internal Medicine, Gifu University Graduate School of Medicine, Gifu City, Japan.
Yamazaki
Tsutomu
T
Kitabatake
Akira
A
Yamaguchi
Tetsu
T
Kanmatsuse
Katsuo
K
Kodama
Itsuo
I
Takekoshi
Noboru
N
Tomoike
Hitonobu
H
Hori
Masatsugu
M
Matsuzaki
Masunori
M
Takeshita
Akira
A
Shimbo
Takuro
T
Fujiwara
Hisayoshi
H
D054058:Acute Coronary Syndrome / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D000328:Adult; D000368:Aged; D000787:Angina Pectoris / Q000209:etiology / Q000517:prevention & control; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects; D002317:Cardiovascular Agents / Q000627:therapeutic use*; D003131:Combined Modality Therapy; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D005260:Female; D006801:Humans; D015994:Incidence; D007564:Japan; D053208:Kaplan-Meier Estimate; D008297:Male; D008875:Middle Aged; D016016:Proportional Hazards Models; D018570:Risk Assessment; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome
D002317:Cardiovascular Agents