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

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)