Angioplasty may be no better than medical treatment for non-acute heart disease

In the West the use of percutaneous transluminal coronary angioplasty (PCTA) has increased over recent years. In a systematic review, Bucher et al (p 73) identified six randomised controlled trials in over 1900 patients that compared PCTA with medical treatment. In non-acute coronary heart disease PCTA reduced angina but resulted in a higher risk of need for coronary bypass grafting during later stages of the disease. For other end points, such as myocardial infarction, death, coronary bypass grafting, and repeated angioplasty, risk ratios all showed trends in favour of medical treatment. Although angioplasty is increasingly used in non-acute coronary heart disease, evidence on its effects on myocardial infarction, death, or subsequent revascularisation is limited because trials have not included sufficient patients for informative estimates.

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Relevant Article

Percutaneous transluminal coronary angioplasty versus medical treatment for non-acute coronary heart disease: meta-analysis of randomised controlled trials

Heiner C Bucher, Peter Hengstler, Christian Schindler, and Gordon H Guyatt
BMJ 2000 321: 73-77. [Abstract] [Full Text] [PDF]