A new study shows that there's little to choose between angioplasty and medical treatment as far as long-term outcome is concerned for elderly patients with angina.

If someone has symptomatic and disabling angina, they can be treated either with drugs or have a revascularization procedure to open up a blocked artery. The best choice is not always easy to judge. Now researchers in Switzerland reveal that there may, in fact, be little difference in outcomes between the two approaches.

The study was a one year follow up on the Trial of Invasive versus Medical therapy in Elderly patients (TIME) study. This had shown early advantage for invasive treatment over drug treatment in terms of quality of life. In the follow up, 282 patients with significant angina were assigned to revascularization or optimized medical treatment. After one year, there were clear benefits in terms of quality of life and improvement in angina for both groups - and the apparent superiority of invasive treatment had disappeared. Those on medical therapy were more likely to be re-admitted to hospital, but at the end of the study both quality of life and survival rates were similar in the two groups. The study suggests that choice of treatment should be individualized to the patient's condition and that personal preferences should be given significant emphasis.

Source

Journal of the American Medical Association 5th March 2003