Features November 2008 Issue

Stents and Medication Therapy Offer Equal Angina Relief After Three Years

Stents may provide quicker relief and may be best suited for more serious cases, but drug therapy alone is sometimes enough to achieve similar results.

Utilizing the combination of stents and optimal medical therapy may make your angina symptoms subside faster than if you relied on medical therapy alone, but according to analysis of the landmark COURAGE trial, published in the Aug. 14 issue of the New England Journal of Medicine, the advantage of stenting for symptom relief ends at around 36 months. The COURAGE trial was the controversial 2007 study that followed 2,287 patients with stable coronary artery disease (CAD), and found there was no advantage, in terms of mortality or heart attack, in using an initial dual strategy of stenting and medical therapy, compared with an initial approach using optimal medical therapy only. Study participants were questioned about their quality of life and frequency of angina after starting medical therapy or after stent implantation. And while stent patients reported fewer bouts with angina and a higher quality of life throughout the first year, by the third year both sets of patients offered almost identical responses.

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