Drugs or Angioplasty?

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By Medstar

M50o93H7pQ09L8X1t49cHY01Z5j4TT91fGfr Drugs or Angioplasty?

Published: Thu, November 29, 2007 - 11:05 am
Last Updated: Thursday, November 29, 2007 - 2:43 pm

Ed Nowak has braved a lot. "Carotid artery, I was operated on both sides. I had cataracts in both eyes, so I'm like a new man, really!"
This 76-year-old also manages diabetes and high blood pressure. On top of all that, Ed's doctor told him he had a heart problem.
"There is an artery, back of your heart, that's too dangerous to operate on. So he says, 'we're just going to go ahead and do it with medication.'"
Ed enrolled in the "courage" study, which gave patients the chance to manage coronary artery disease without angioplasty.
"What if we give that patient a trial of optimal medical therapy as opposed to simply saying, 'you need angioplasty,' right from the get go."
In Dr. Boden's study, about half of the patients took drugs to address their specific problems.
"Aspirin, beta blockers, statins, ace inhibitors, you know, these are standard treatments that we employ all the time in the routine care of our patients."
The drug therapy treated the entire vascular system, and targeted fatty lipids that cause blockages.
"Aggressive medical therapy actually shrinks the lipid core inside the artery and makes the vulnerable plaques less vulnerable to rupture."
Overall, the study found two-thirds of patients on drug therapy never needed angioplasty.
"A course of medical therapy is safe and it's equally effective as, as angioplasty and stenting."
Results that encourage Ed to keep up with his medicine.
Over the course of the seven-year study, death rates and revascularization rates, meaning patients needing an artery opened, were nearly the same between the drug therapy group versus the angioplasty and stent group. Dr. Boden says that in addition to drug therapy, lifestyle and dietary changes were also important to patient success.

Fast Facts:
15.8 million people in the U.S. have coronary artery disease.
The courage trial recently compared the effects of intensive medical therapy versus those receiving angioplasty plus intensive medical therapy in patients with stable coronary artery disease.
Investigators found angioplasty did not offer any significant advantages over intensive medical therapy alone. Both groups of patients had similar rates of heart attack, stroke and death.

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