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  • Title: 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.
    Author: Nishigaki K, Yamazaki T, Kitabatake A, Yamaguchi T, Kanmatsuse K, Kodama I, Takekoshi N, Tomoike H, Hori M, Matsuzaki M, Takeshita A, Shimbo T, Fujiwara H, Japanese Stable Angina Pectoris Study Investigators.
    Journal: JACC Cardiovasc Interv; 2008 Oct; 1(5):469-79. PubMed ID: 19463347.
    Abstract:
    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.
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