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BMJ 2006;333:672 (30 September), doi:10.1136/bmj.333.7570.672
London Susan Mayor
Percutaneous coronary intervention, also known as angioplasty, is as effective as coronary artery bypass grafting in treating patients with refractory angina who are at high risk of adverse outcomes, a new US study has concluded. It found that over five years angioplasty is nearly 20% cheaper.
An earlier study had randomised high risk patients with medically refractory myocardial ischaemia—a group of patients who have largely been excluded from previous trials—to urgent revascularisation with either angioplasty or coronary artery bypass grafting.
Results for the 454 patients, who were recruited from 16 medical centres of the US Department of Veterans Affairs, showed that survival at three years was 0.82 for patients who had angioplasty and 0.79 for those who had grafting (P for difference 0.34). Survival remained similar for both procedures at five years: 0.75 for angioplasty and 0.7 for grafting (P=0.21).
New results from a cost analysis of
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