Why the study?
Is optimal medical therapy as effective as myocardial revascularization in reducing adverse clinical outcomes in patients with chronic CAD and stable angina?
Is optimal medical therapy as effective as myocardial revascularization in reducing adverse clinical outcomes in patients with chronic CAD and stable angina?
Optimal medical therapy is highlighted as being as effective as revascularization for chronic CAD, supporting evidence-based guideline recommendations.
Supports guideline emphasis on optimal medical therapy for stable CAD; leaves open individualized revascularization decisions pending prospective trials.
The primary objective of treatment in patients with chronic coronary artery disease (CAD) and stable angina is relief of symptoms and improvement of clinical outcome. The American College of Cardiology/American Heart Association guidelines have emphasized the role of evidence-based therapies. There have been regular updates of the guidelines, with an effort to include the latest data in the recommendations. Since the 2002 guidelines were published, there have been several pivotal studies that have provided strong support for the role of aggressive and optimal medical therapy in improving clinical outcomes in patients with chronic CAD. Recent data from 2 landmark studies have emphasized that optimal medical therapy is as effective as myocardial revascularization with percutaneous coronary intervention or coronary artery bypass grafting in reducing risk of adverse clinical outcomes. The 2009-2010 guidelines will likely incorporate the findings of these studies and accordingly modify the recommendations for treatment of patients with chronic CAD and stable angina.
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Deedwania et al. (2009) studied this question.
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