Heart Beat: Drugs, angioplasty nearly equal for angina relief
Drugs, angioplasty nearly equal for angina relief
In 2007, the results of the COURAGE trial forced doctors to rethink how stable angina (chest pain with exercise or stress) should be treated. In the trial, artery-opening angioplasty with stent placement, which over the years had become a first-line treatment for angina, was no better than aggressive drug therapy at preventing heart attacks or extending life. An analysis of the trial shows that both treatments rapidly decreased the frequency of angina attacks and helped people feel better and be more active (New England Journal of Medicine, August 14, 2008).
The improvements happened a bit quicker with angioplasty. Within two years, though, there were no differences in angina, physical function, and quality of life between people treated with angioplasty or medical therapy.
A surprise from the trial was how fast drug therapy helped quell angina and improve the ability to exercise and be active. It was most effective for people who had bouts of chest pain once a week or less. For those with angina several times a week, angioplasty had a small edge.