Authors' objectives:

1. To establish the extent to which the indications for coronary artery interventions coincide with the scientific evidence. 2. To establish the extent to which the indications were uniformly adhered to throughout Sweden. 3. To establish the extent to which the interventions lead to the intended improvement in symptoms 4. To identify the relationship between the appropriateness of the indications with the final outcomes for the patients 5. To gain experience concerning RAM as a method to register and assess indications.

Authors' recommendations: The follow-up shows that: mortality, with or without intervention, is low during the first 2 years, patients often become free from symptoms, patients' physical capacity increases substantially, patients are satisfied with their treatment. For patients, CABG represents a major intervention with substantial pain in conjunction with the surgery, followed by a prolonged period of being free from symptoms. The patients who underwent PTCA experienced fewer problems in conjunction with the intervention itself. However, one third of these patients required further treatment, either PTCA or surgery. There is scientific support for the use of surgery, mainly in patients who have occlusions in the left main branch or in all three main branches, since the procedure has been shown to lengthen life and reduce symptoms. Most of the patients who received surgery belonged to this group. Most of the patients who were referred to PTCA either had borderline significant occlusions or occlusions in one or two main branches. Here, PTCA has not been shown to lengthen life and is therefore used to relieve symptoms. The scientific evidence for selecting PTCA or continuing with drug therapy was limited. It is not possible to draw conclusions concerning the patients who were referred to continued drug therapy although, according to the Delphi panel, they met the criteria for intervention.

Authors' methods: Review and survey

Project Status: Completed

URL for project: http://www.sbu.se/Published

Year Published: 1998

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: Sweden

Organisation Name: Swedish Agency for Health Technology Assessment and Assessment of Social Services

Contact Address: P.O. Box 3657, SE-103 59 Stockholm, Sweden. Tel: +46 8 4123200, Fax: +46 8 4113260

Contact Name: registrator@sbu.se

Contact Email: registrator@sbu.se

Copyright: The Swedish Council on Technology Assessment in Health Care (SBU)