[Effectiveness of invasive treatment for coronary artery disease: overview of systematic reviews]

Kuukasjarvi P, Malmivaara A, Makela M and Working Group
Record ID 32005001406
Original Title: Sepelvaltimotaudin kajoavan hoidon vaikuttavuus
Authors' objectives:

This report examines the clinical effectiveness of invasive treatment in stable coronary heart disease, coronary heart attacks and myocardial infarction (ST-elevation MI) on the basis of a systematic review of the literature.

Authors' recommendations: Surgery seems to offer more lasting help for chest pain symptoms (angina pectoris) than angioplasty with or without stent. There is no research data available on a comparison between drug eluting stent and surgical treatment. Evidence of the benefits of drug eluting stents is based to date on research on patients who primarily have just one diseased coronary artery, and follow-up times have been short. The use of drug eluting stents leads to a reduction in the need for repeat angioplasty, but the need for repeated surgical treatment is not reduced. In patients with unstable angina pectoris syndrome and non-ST-elevation MI (i.e. patients with a heart attack), an early invasive treatment strategy could save 1-2 lives per one hundred patients treated in this manner compared with early conservative treatment strategy. A statistical examination of this treatment effect may, however, include the possibility that treatment does not reduce mortality at all or even increases it. The routine use of angioplasty as treatment for ST-elevation MI instead of fibrin specific thrombolytic agents would prevent the death of 1-2 patients, and the occurence of 3-6 new myocardial infarctions per 100 patients treated with angioplasty, over a follow-up of 1-12 months. In addition, one patient out of 100 would be prevented from having a stroke during the following six months.
Authors' methods: Overview
Project Status: Completed
Year Published: 2005
URL for published report: http://urn.fi/URN:NBN:fi-fe201204194058
English language abstract: An English language summary is available
Publication Type: Not Assigned
Country: Finland
MeSH Terms
  • Angina Pectoris
  • Coronary Disease
  • Myocardial Infarction
  • Angina Pectoris
  • Coronary Disease
  • Myocardial Infarction
  • acute disease
  • treatment outcome
  • randomized controlled trials
Organisation Name: Finnish Coordinating Center for Health Technology Assessment
Contact Address: Finnish Office for Health Care Technology Assessment (Finohta)
Contact Name: .
Contact Email: fincchta@ppshp.fi
Copyright: Finnish Office for Health Care Technology Assessment (FinOHTA)
This is a bibliographic record of a published health technology assessment from a member of INAHTA or other HTA producer. No evaluation of the quality of this assessment has been made for the HTA database.