Drugs Still Best First Step for Non-Acute Heart Disease

Despite technological advances, catheter-based treatments offer no advantage

FRIDAY, Mar. 13 (HealthDay News) -- Medical therapy is still the best initial management strategy for non-acute coronary artery disease despite innovations in catheter-based treatment, according to a study published in the Mar. 14 issue of The Lancet, while a second study describes the positive initial findings of a phase II trial of SCH 530348, an oral platelet protease-activated receptor-1 antagonist used in percutaneous coronary intervention.

Thomas A. Trikalinos, M.D., of Tufts Medical Center in Boston, and colleagues conducted a meta-analysis of 61 trials comprising 25,388 patients, which compared four interventions for non-acute coronary artery disease: percutaneous transluminal balloon coronary angioplasty, bare-metal stents, drug-eluting stents and medical therapy. They found that there was no evidence of improved mortality or myocardial infarction rates with catheter-based treatments versus medical therapy.

Richard C. Becker, M.D., of the Duke Clinical Research Institute in Durham, N.C., and colleagues conducted a trial of 1,030 patients undergoing non-urgent percutaneous coronary intervention (PCI) or coronary angiography with planned PCI, of whom 773 received a 10 mg, 20 mg or 40 mg dose of SCH 530348, and 257 received placebo. They found that the drug was well-tolerated and did not increase thrombolysis in myocardial infarction bleeding.

"Our study provides preliminary evidence for the feasibility and safety of thrombin receptor inhibition among patients with coronary artery disease undergoing percutaneous coronary intervention," Becker and colleagues write. "Phase III studies will be needed to provide further information on safety and efficacy."

The second study was funded by Schering-Plough Research Institute, Kenilworth, N.J., and several authors have received funding or fees from or are employed by Schering-Plough Research Institute.

Abstract - Trikalinos
Full Text (subscription or payment may be required)
Abstract - Becker
Full Text (subscription or payment may be required)

Related Stories

No stories found.