VIEWPOINT
PCI or CABG: which patients and at what cost?
1 Glenfield Hospital, Leicester, UK
2 Kings College Hospital, London, UK
Correspondence to:
Dr M Thomas, Department of Cardiology, Kings College Hospital, Denmark Hill, London SE5 9RS, UK; mttwins@aol.com
Accepted 28 May 2007
Abbreviations: AMI, acute myocardial infarction; BMS, bare metal stents; CABG, coronary artery bypass grafting; DES, drug-eluting stent; OMT, optimal medical treatment; PCI, percutaneous coronary intervention
Keywords: percutaneous coronary intervention; coronary bypass grafting
| The first 150 words of the full text of this article appear below. |
Major changes in the management of symptomatic obstructive coronary artery disease have been seen in the past 10 years with a substantial shift towards percutaneous coronary intervention (PCI). In the UK in 2005, for example, 73 000 PCIs were performed compared with 22 000 isolated coronary artery bypass grafting (CABG) procedures.1 Recently, there has been much debate about which of these two revascularisation options is "better" as measured by clinical outcome and overall cost effectiveness. This editorial will attempt to redress the balance on the use of PCI versus medical treatment in stable angina and its use in multivessel disease.
Some have interpreted the recently published COURAGE trial,2 which randomised (after coronary angiography) 2287 patients with positive non-invasive tests to either optimal medical treatment (OMT) or PCI, as indicating that OMT is equivalent to PCI for stable coronary artery disease and suggested that PCI is an overcostly, overused procedure.
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