Case for angioplasty to treat angina

doi:10.1136/bmj.39185.442731.3A

BMJ 2007;334:813 (21 April), doi:10.1136/bmj.39185.442731.3A

Letters

Coronary artery disease

Case for angioplasty to treat angina

The first 150 words of the full text of this article appear below.

The COURAGE trial results show that patients with stable coronaryartery disease who have a good quality of life while receivingmedical treatment do not require an angioplasty.¹ Coronary angioplastyin the United Kingdom is generally used to treat stable patientswho have angina while receiving medical treatment. This trialtherefore has little relevance to UK practice.

Of patients randomised, 43% had little or no angina. In additionone third of patients in the "optimal medical treatment" armhad an angioplasty by 4.6 years, presumably because of anginawhile receiving optimal medical treatment. It would be interestingto know how many of these patients started the trial with important(class II or III) angina. The trial may actually show that mostpatients with class II or III angina will require an angioplastywithin five years because optimal medical treatment will notcontrol their symptoms. The primary end point of death . . . [Full text of this article]

Martyn R Thomas, president, British Cardiovascular Intervention Society

King's College Hospital, London SE5 9RS

mttwins@aol.com