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(Circulation. 2003;108:e9027.)
© 2003 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Percutaneous Intervention a Winner—Even in Patients With Stable, Single-Vessel Disease

Even though the question had never been answered in a clinical trial, most cardiologists have recommended that patients who have survived acute myocardial infarction without residual symptoms or ischemia undergo percutaneous transluminal angioplasty of the affected artery. In this small trial, Uwe Zeymer, MD, of the Klinikum Ludwigshafen, Medizinische Klinik B, Ludwigshafen, Germany, and his colleagues demonstrated that there is clinical benefit to the procedure in this group of patients. They urge that larger studies be carried out to confirm their results (Circulation. 2003;108:1324–1328.)

The physicians randomly assigned 300 patients with single-vessel disease of the infarct vessel and no or minor angina after an acute myocardial infarction to receive either angioplasty (n=149) or medical therapy (n=151). After one year, 82% of patients in the medically treated group and 90% in the angioplasty group were alive and had suffered no related events. The difference was mainly in the need for intervention. There were 20 interventions in the medically treated patients versus 8 in those who had undergone primary percutaneous intervention. After a follow-up that averaged 56 months, 89% of patients in the medically treated group were alive versus 96% in the percutaneous intervention group. The percentage of those who survived without another myocardial infarction, (re)intervention, or coronary artery bypass graft surgery was 66% in the medically treated group and 80% in the percutaneous intervention group. The angioplasty group was less likely to use nitrates, as well.

The authors concluded, "Percutaneous revascularization of the infarct-related coronary artery in stable patients . . . [Full Text of this Article]