January 1, 2006Circulation JournalOpen Access

Outcomes of Patients With Stable Low-Risk Coronary Artery Disease Receiving Medical- and PCI-Preceding Therapies in Japan J-SAP Study 1-1

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Why the study?

Does a medical-preceding therapy strategy reduce clinical events or medical costs compared to a PCI-preceding therapy strategy in patients with stable low-risk coronary artery disease?

Population

382 Japanese patients with stable low-risk coronary artery disease, mean age ~66 years, ~74% male. Excluded…

Comparison

Medical-preceding therapy vs PCI-preceding therapy, matched for age, gender…

Design

Cohort

Follow-up

mean 3.4 years

Authors

STShintaro TanihataGifu Prefectural General Medical Center KNKazuhiko NishigakiGifu University MKMasanori KawasakiCardiac Imaging

Discussion

Member takes

Implication

Comparable outcomes at lower cost with medical-first strategy in this cohort; leaves open confirmation in randomized trials.

Structured PICO

Does a medical-preceding therapy strategy reduce clinical events or medical costs compared to a PCI-preceding therapy strategy in patients with stable low-risk coronary artery disease?

Population

382 Japanese patients with stable low-risk coronary artery disease (defined as 1- or 2-vessel disease excluding ostial lesions of the left anterior descending artery, with >75% stenosis), mean age ~66 years, ~74% male. Excluded: patients with acute coronary syndrome.

Intervention

Medical-preceding therapy (initial administration of anti-anginal agents to control attacks, with percutaneous coronary intervention considered only if medical therapy is not effective)

Comparator

PCI-preceding therapy (initial treatment with percutaneous coronary intervention combined with medical therapy), matched for age, gender, severity of angina, and number of lesion vessels

Outcome

Composite of cardiac death or acute coronary syndrome (ACS) over a mean follow-up of 3.4 yearscomposite

In Japanese patients with stable low-risk coronary artery disease, an initial medical therapy strategy yields similar long-term clinical outcomes to an initial PCI strategy but at a significantly lower medical cost.

Limitations

Retrospective matching of consecutive patients rather than true randomization
Subjects were not general patients with low-risk CAD, reflected in a higher incidence of noncardiac death in the medical group
Improvement of anginal symptoms in the short term after treatment was not examined
Small sample size

Cite This Study

Tanihata et al. (2006) studied this question.

synapsesocial.com/papers/6a71fb2375498292b70b43bc https://doi.org/10.1253/circj.70.365

Topics

Coronary artery disease

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Outcomes of Patients With Stable Low-Risk Coronary Artery Disease Receiving Medical- and PCI-Preceding Therapies in Japan J-SAP Study 1-1

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

Topics

Outcomes of Patients With Stable Low-Risk Coronary Artery Disease Receiving Medical- and PCI-Preceding Therapies in Japan J-SAP Study 1-1

Discussion

Member takes

Implication

Structured PICO

Limitations

Cite This Study

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Topics

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