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    Stents do NOT reduce the risk of heart attack, stroke and death over 4.6 years


    Posted by .(JavaScript must be enabled to view this email address)
    Sunday, July 26, 2015 4:51 am Email this article

    Coronary artery stents do NOT reduce the risk of heart attack, stroke and death over 4.6 years according to the Clinical Outcomes Uti­lizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial.

    Five percent (5%) MORE people given stents had a heart attack, stroke or died over 4.6 years compared to those who did NOT have a stent (20.0% of people given a stent versus 19.5% of people who did NOT have a stent), although the difference was not statistically significant.

    At the very least, this shows that stents do NOT reduce the risk of heart attack, stroke and death, and may INCREASE the risk of heart attack, stroke and death.

    Heart Attacks

    13% MORE Heart Attacks in those given stents

    People given stents had 13% MORE heart attacks over 4.6 years compared to those not given a stent (13.2% of people given a stent versus 12.3% of people NOT given a stent), although the difference was not statistically significant.

    Hospitalizations

    7% MORE Hospitalizations for acute coronary syndrome in those given stents

    People given stents had 7% MORE hospitalization for acute coronary syndrome over 4.6 years compared to those not given a stent (12.4% of people given a stent versus 11.8% of people NOT given a stent), although the difference was not statistically significant.

    Conclusion

    Conclusion: Stents have NO effect in reducing heart attack, stroke or death

    “In the aggregate, these studies, including our own, include outcome data on more than 5000 patients [from 3 studies including this one] and show that PCI [stents] has no effect in reducing major cardiovascular events.”

    “Although the addition of PCI [stents] to optimal medical therapy reduced the prevalence of angina, it did not reduce long-term rates of death, nonfatal myocardial infarction, and hospitalization for acute coronary syndromes,” the authors concluded.

    Subjects

    Subjects: 2287 patients

    “We conducted a randomized trial involving 2287 patients who had objective evidence of myocardial ischemia and significant coronary artery disease at 50 U.S. and Canadian centers,” the paper notes.

    “Between 1999 and 2004, we assigned
    1149 patients to undergo PCI with optimal medical therapy (PCI group) [giving people stents] and
    1138 to receive optimal medical therapy alone (medical-therapy group) [NO stents].

    “The primary outcome was death from any cause and non-fatal myocardial infarction (non-fatal heart attack) during a follow-up period of 2.5 to 7.0 years (median, 4.6).

    Reference

    Boden WE, O’Rourke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk WJ, Knudtson M, Dada M, Casperson P, Harris CL, Chaitman BR, Shaw L, Gosselin G, Nawaz S, Title LM, Gau G, Blaustein AS, Booth DC, Bates ER, Spertus JA, Berman DS, Mancini GB, and Weintraub WS. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med, 2007 Apr 12; 356(15): 1503-1516.

    Author’s Contact Info

    W. E. Boden
    Western New York Veterans Affairs Healthcare Network and
    Buffalo General Hospital-SUNY
    Buffalo, NY 14203, USA.
    .(JavaScript must be enabled to view this email address)

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