Patients with stable heart disease are often urged to have angioplasty and a cardiac stent placed in a coronary artery. A large study several years ago, however, demonstrated that such an intervention is no better than appropriate treatment with medications when it comes to preventing heart attacks and death. This trial was known by the acronym COURAGE, which stands for Clinical Outcomes Utilizing Revascularization And Aggressive Drug Evaluation.
The investigators of a new study published in the Journal of the American Medical Association wanted to know whether the results of the COURAGE trial had made a difference in cardiology practice. They examined the records of nearly 500,000 patients who were experiencing chest pain brought on by blockage in coronary arteries. Only 44 percent of the patients who were scheduled for angioplasty and stenting were already taking the recommended medications: aspirin to prevent blood clots, a beta blocker to preserve heart function and a statin to lower cholesterol. The investigators concluded that the evidence from the COURAGE trial made virtually no difference in what interventional cardiologists recommend for their patients with heart disease.
[Journal of the American Medical Association, May 11, 2011]
