Pain Relief in Coronary Artery Disease Treatments

Patients with mid-range coronary artery disease (CAD) are more likely to get relief from painful angina and less likely to have repeat procedures if they receive coronary artery bypass graft (CABG) surgery rather than balloon angioplasty (with or without a stent), according to a new study.

Researchers at the U.S. Agency for Healthcare Research and Quality (AHRQ, Rockville, MD, USA) analyzed 23 randomized controlled trials that compared treatments for patients with mid-range coronary disease--defined as a single blockage of the vital left anterior descending artery, blockage of two arteries, or some forms of less-severe blockage of three arteries--treatable with either angioplasty or CABG surgery.

The report found that about 84% of patients who undergo CABG surgery are free of angina pain one year after the procedure, compared with about 75% of patients who receive angioplasty. The difference narrows but remains substantial five years after treatment. The study also found that for mid-range coronary artery disease, CABG and angioplasty patients had about the same survival rates and similar numbers of heart attacks, but that bypass surgery presents a slightly higher risk of stroke within 30 days of the procedure. A summary of the report was published in the October 2007 issue of Annals of Internal Medicine.

"Choosing a treatment for coronary disease has long been a difficult challenge,” said Carolyn M. Clancy, M.D., director of the AHRQ. "But this new evidence-based report provides a vital reference to help doctors, patients, and their families make the best possible decision.”


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