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NEW ORLEANS—Patients with stable coronary artery disease treated with stents and optimal medical therapy fare no better than those who receive optimal medical therapy alone, according to new findings from a large clinical trial.
For many cardiologists, the results serve as a wake-up call that they need to reevaluate how frequently they offer stenting (which has slight risks associated with the intervention itself as well as stent-associated thrombotic events) as a first option for relief of stable angina. The data come from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial, reported here in March at the annual conference of the American College of Cardiology.
Medical therapy, including drugs for hypertension, dyslipidemia, and clotting, along with lifestyle modification programs, should be the first treatment options for patients with stable coronary artery disease.
The COURAGE trial involved 2297 patients with at least one coronary artery that
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