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Coronary Stenting Doesn't Hold Up Well in Meta-Analyses — Physician’s First Watch

Medical News |
December 3, 2013

Coronary Stenting Doesn't Hold Up Well in Meta-Analyses

By Joe Elia

Two meta-analyses in JAMA Internal Medicine bring discouraging news to fans of percutaneous coronary intervention (PCI).

The first, an analysis of long-term (mean, 4-year) outcomes in multivessel disease, gives the advantage to coronary artery bypass grafting for total mortality (relative risk, 0.73), incident myocardial infarction (0.58), and repeat revascularization (0.29). The analysts note a nonsignificant trend toward more strokes with grafting, but the absolute risk was low. Patients' diabetes status had no effect on the findings.

The second meta-analysis looked at the effect of adding PCI to medical therapy in patients with stable obstructive disease and proven myocardial ischemia. Again, the findings didn't favor PCI, which added no discernible advantage over medical therapy alone with regard to all-cause death, nonfatal MI, unplanned revascularization, or angina over the median 5-year follow-up.

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