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Effects of different therapies on coronary artery disease
Shuzheng Lü1, Wenxian Liu, Xiantao Song
1Beijing Institute of Heart, Lung and Blood Vessel Disease, Beijing Anzhen Hospital, Beijing 100029, China.
Insights
Percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) reduce angina recurrence in coronary artery disease (CAD) patients compared to drug therapy. However, no therapy significantly improved long-term survival, except for left main CAD where PCI and CABG showed better outcomes.
Area of Science:
- Cardiology
- Interventional Cardiology
- Clinical Medicine
Background:
- Coronary artery disease (CAD) poses a significant global health burden.
- Optimal therapeutic strategies for CAD remain a focus of clinical research.
- Comparing revascularization techniques against medical management is crucial for patient outcomes.
Purpose of the Study:
- To analyze and compare the efficacy of three distinct treatment modalities for coronary artery disease (CAD).
- To evaluate the short-term and long-term effects of pure drug therapy, percutaneous coronary intervention (PCI), and coronary artery bypass graft (CABG) on major adverse cardiac events (MACEs).
- To assess the impact of these therapies on angina recurrence and overall patient quality of life.
Main Methods:
- A cohort of 1055 patients diagnosed with CAD via coronary angiography were stratified into three groups: drug therapy, PCI, and CABG.
- Follow-up assessments were conducted to monitor major adverse cardiac events (MACEs), including death, myocardial infarction (MI), and revascularization.
- Long-term evaluation focused on angina recurrence and improvement, with short-term (30 days post-discharge) and long-term (beyond 30 days) periods defined.
Main Results:
- Both PCI and CABG groups demonstrated significantly lower rates of angina recurrence compared to the pure drug therapy group in the long term (P < 0.05).
- No significant differences in overall long-term endpoint events were observed across the three treatment groups (P > 0.05).
- In patients with left main coronary disease, PCI and CABG showed superior outcomes with no mortality or MI, unlike drug therapy (P = 0.015). Short-term mortality was higher in the CABG group (5.77%) compared to PCI (1.91%) and drug therapy (1.40%) (P = 0.002).
Conclusions:
- Percutaneous coronary intervention (PCI) effectively reduces angina episodes and enhances patient quality of life.
- While PCI improves angina symptoms, it does not significantly extend long-term survival in general CAD patients.
- For left main coronary artery disease, PCI and CABG offer survival benefits over medical management, highlighting their importance in specific complex cases.
Objective:
To analyse the effects of different therapies on coronary artery disease (CAD).
Methods:
A total of 1055 patients who suffered from CAD diagnosed by coronary angiography were divided into three groups, namely pure drug therapy, percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) groups. Follow up was carried out from March to May in 2001, and the major adverse cardiac events (MACEs) including death, no-lethal myocardial infarction (MI) and revascularization were observed. In long-term observation, angina reoccurred, and their improvement was evaluated. The short-term period was defined as the duration of 30 days after discharge, and the long term period was defined as the duration from 30 days after discharge.
Results:
In the long-term period, the recurrences of angina both in PCI group and CABG group were lower than pure drug group (P 0.018, 0.002 respectively). No differences about long-term endpoint events were observed among these three groups (P > 0.05). Forty-two patients suffering from left main coronary disease were intervened by the three therapies, and there was no death or MI both in PCI and CABG groups, three patients died and suffered from AMI in pure drug therapy group (P = 0.015). In the short-term period, mortality in CABG group (5.77%) was higher than those in the other two groups (1.91% for PCI, and 1.40% for medical therapy, P = 0.002), and no obvious difference observed in the latter two groups. No significance was concluded about the recent MI among this three groups (P = 0.357). There were no differences on revascularization in these three groups.
Conclusions:
Percutaneous coronary interventions can not only reduce the attack of angina but also improve the life quality of patients, however it can not improve the long-term existence but left main CAD.
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