Clinical Research
Percutaneous Coronary Intervention Plus Medical Therapy Reduces the Incidence of Acute Coronary Syndrome More Effectively Than Initial Medical Therapy Only Among Patients With Low-Risk Coronary Artery Disease: A Randomized, Comparative, Multicenter Study

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Objectives

This study sought to determine whether initial medical therapy (MT) only or percutaneous coronary intervention plus medical therapy (PCI+MT) is better for patients with low-risk stable coronary artery disease (CAD) indicated for intervention in Japan.

Background

Several multicenter studies have suggested that in the above patients, an initial management strategy of PCI+MT does not reduce the long-term risk of cardiovascular events more effectively than initial MT only.

Methods

We conducted a randomized comparative study (JSAP [Japanese Stable Angina Pectoris] study) in the previously mentioned patients.

Results

The patients were randomized to PCI+MT (n = 192) or initial MT only group (n = 192), and the patient characteristics were very similar in the 2 groups. During the 3.3-year follow-up, there was no significant difference in the cumulative death rate between PCI+MT (2.9%) and MT (3.9%). However, the cumulative risk of death plus acute coronary syndrome was significantly smaller in PCI+MT.

Conclusions

In stable low-risk CAD, PCI+MT may improve long-term prognosis more effectively than MT.

Key Words

angina pectoris
randomized trial
long-term prognosis

Abbreviations and Acronyms

ACS
acute coronary syndrome
AMI
acute myocardial infarction
CAD
coronary artery disease
CAG
coronary arteriography
CI
confidence interval
CVA
cerebrovascular accidents
ECG
electrocardiogram
LAD
left anterior descending artery
MT
medical therapy
PCI
percutaneous coronary intervention
UAP
unstable angina pectoris

Cited by (0)

Sponsorship and oversight of the JSAP Study were provided by a Health and Labour Sciences Research Grant from the Japanese Ministry of Health, Labour, and Welfare and the Japan Heart Foundation (Tokyo, Japan)