- Home>
- Specialty Care>
- Cardiology>
- Summary and Comment
Angioplasty or Medical Treatment for Stable Angina?
The role of revascularization in the treatment of stable angina pectoris remains controversial. In this trial, 20 centers in the United Kingdom and Ireland randomized 1,018 patients with documented stable angina to receive either coronary artery angioplasty or medical therapy.
Seventy-nine percent of patients had angina grade 2 or lower, and nearly all had one- or two-vessel disease (median age, 58; 82 percent male). Left ventricular function was normal or only mildly impaired in 94 percent of patients.
At a median follow-up of 2.7 years, the risk of death or nonfatal MI was significantly higher in the angioplasty group than in the medical management group (6.3 percent vs. 3.3 percent), largely due to procedure-related events. At one year, 14.9 percent of the angioplasty group and 15.4 percent of the medically treated patients required revascularization. However, PTCA was more effective at relieving angina and improving exercise time. At two years, there was an excess of 7.6 percent of grade 2 angina in the medical group. PTCA's benefits were highest in patients with grade 2 or worse angina and an exercise time of less than 9 minutes.
Comment: Based on these results, moderate improvements in anginal symptoms among angioplasty-treated patients appear to be offset by a risk of procedure-related death and MI. This would suggest that medical therapy is as effective as coronary artery angioplasty in treating patients with stable angina.
— KA Eagle
Published in Journal Watch Cardiology September 23, 1997
Citation(s):
RITA-2 Trial Participants. Coronary angioplasty versus medical therapy for angina: The second Randomised Intervention Treatment of Angina (RITA-2) trial. Lancet 1997 Aug 16 350 461-468.
- Medline abstract (Free)