How should stable coronary artery disease be managed  in the modern era?

Woollard, Keith V; Newman, Mark A J

doi:10.5694/j.1326-5377.2007.tb01169.x

Topics

CABG offers a cost-effective and better long-term clinical outcome for many patients

Coronary artery disease is still the single largest cause of premature death in Australia, according to the Australian Institute of Health and Welfare.1 Also documented is the dramatic decline in age-related mortality from heart disease, which is largely attributed to reductions in smoking and better intervention for hyperlipidaemia and elevated blood pressure.2

1 Murdoch Medical Centre, Perth, WA.
2 Sir Charles Gairdner Hospital, Perth, WA.

Correspondence: KeithWoollard@wacardiology.com.au

1. Begg S, Vos T, Barker B, et al. The burden of disease and injury in Australia 2003. Canberra: AIHW, 2007. (AIHW Cat. No. PHE 82.) http://www.aihw.gov.au/publications/index.cfm/title/10317 (accessed Jul 2007).
2. Unal B, Critchley JA, Capewell S. Explaining the decline in coronary heart disease mortality in England and Wales between 1981 and 2000. Circulation 2004; 109: 1101-1107.
3. Boden WE, O’Rouke RA, Teo KK, et al; COURAGE Trial Research Group. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007; 356: 1503-1516.
4. Myocardial infarction and mortality in the coronary artery surgery study (CASS) randomized trial. N Engl J Med 1984; 310: 750-758.
5. Eleven-year survival in the Veterans Administration randomized trial of coronary bypass surgery for stable angina. The Veterans Administration Coronary Artery Bypass Surgery Cooperative Study Group. N Engl J Med 1984; 311: 1333-1339.
6. Varnauskas E. Twelve-year follow-up of survival in the randomized European Coronary Surgery Study. N Engl J Med 1988; 319: 332-337.
7. Berger PB, Sketch MH, Califf RM. Choosing between percutaneous coronary intervention and coronary artery bypass grafting for patients with multivessel disease: what can we learn from the Arterial Revascularization Therapy Study (ARTS)? Circulation 2004; 109: 1079-1081.
8. Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. The Bypass Angioplasty Revascularization Investigation (BARI) Investigators. N Engl J Med 1996; 335: 217-225.
9. Dinh DT, Billah B, Shardey G, et al. Australasian Society of Cardiac and Thoracic Surgeons. Victorian Cardiac Surgery Database Project. Annual report 2005–2006. http://www.ascts.org/documents/PDF/VIC_Surgeons_report_05-06_Fina.pdf (accessed Jun 2007).
10. Wahrborg P, Booth JE, Clayton T, et al; SoS Neuropsychology Substudy Investigators. Neuropsychological outcome after percutaneous coronary intervention or coronary artery bypass grafting: results from the Stent or Surgery (SoS) Trial. Circulation 2004; 110: 3411-3417.
11. Harper RW. Drug-eluting coronary stents — a note of caution. Med J Aust 2007; 186: 253-255. <MJA full text>
12. Griffin SC, Barber JA, Manca A, et al. Cost effectiveness of clinically appropriate decisions on alternative treatments for angina pectoris: prospective observational study. BMJ 2007; 334: 624-628.
13. Taggart DP. Coronary revascularisation [editorial]. BMJ 2007; 334: 593-594.
14. Gott VL, Patel ND, Yang SC, Baumgartner WA. Attracting outstanding students (premedical and medical) to a career in cardiothoracic surgery. Ann Thorac Surg 2006; 82: 1-3.
15. Hirshfeld JW Jr, Messer JV, Peterson ED, Prystowsky EN. Task force 4: appropriate clinical care and issues of “self-referral”. Circulation 2004; 110: 2528-2534.
16. Fox KA, Anderson FA, Dabbous OH, et al; GRACE investigators. Intervention in acute coronary syndromes: do patients undergo intervention on the basis of their risk characteristics? The Global Registry of Acute Coronary Events (GRACE). Heart 2007; 93: 177-182.

Online responses are no longer available. Please refer to our instructions for authors page for more information.