OMT - cardioegypt2011

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Subgroup Analyses Baseline Characteristics Hazard Ratio (95% Cl) PCI Medical Therapy Myocardial Infarction Yes 1.15 (0.93-1.42) 0.19 0.18 No 0.65 (0.40-1.06) 0.18 0.26 Extent of CAD Multi-vessel disease 1.10 (0.83-1.46) 0.24 0.22 Single-vessel disease 1.00 (0.77-1.32) 0.16 0.16 Diabetes Yes 1.08 (0.87-1.34) 0.19 0.18 No 0.87 (0.54-1.42) 0.19 0.24 Angina CCS 0-I 1.27 (0.90-1.78) 0.17 0.14 CCS II-III 0.71 (0.44-1.14) 0.15 0.21 Ejection Fraction ≤ 50% 1.06 (0.80-1.38) 0.22 0.22 > 50% 1.06 (0.80-1.38) 0.22 0.22 Previous CABG No 1.06 (0.80-1.38) 0.22 0.22 Yes 1.06 (0.80-1.38) 0.22 0.22 R&M Solutions www.rmsolutions.net 0.25 0.50 1.00 1.50 1.75 2.00 PCI Better Medical Therapy Better
Conclusions • As an initial management strategy in patients with stable coronary artery disease, PCI did not reduce the risk of death, MI, or other major cardiovascular events when added to optimal medical therapy • As expected, PCI resulted in better angina relief during most of the follow-up period, but medical therapy was also remarkably effective, with no between–group difference in angina-free status at 5 years R&M Solutions www.rmsolutions.net
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The COURAGE Trial; When optimal med
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COURAGGE is not PCI Vs. OMT PCI add
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A North American Trial 19 US Non-VA
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Primary Outcome Death or Nonfatal M
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Smoking Risk Factor Goals Variable
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Lifestyle Optimal Medical Therapy
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1.0 0.9 0.8 0.7 0.6 0.5 0.0 Number
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1.0 0.9 0.8 0.7 0.6 0.5 0.0 Number
Page 17 and 18: Conclusions (Courage initial study)
Page 19 and 20: Even if PCI added to OMT did not af
Page 21 and 22: Freedom from Angina During Long-Ter
Page 23 and 24: R&M Solutions www.rmsolutions.net
Page 31 and 32: The “Truth and Consequences” of
Page 33 and 34: Ischemia Reduction ‡ 5% 50 40 30
Page 35 and 36: Is this significant releive of isch
Page 37 and 38: Death or MI rate (%) Rates of Death
Page 39 and 40: Conclusions (Courage nuclear substu
Page 41 and 42: Any confirmation from another RCT R
Page 45 and 46: This when OMT including life style
Page 47 and 48: Many Patients in Need of Lipid Lowe
Page 49 and 50: Many Patients that are Treated are
Page 51 and 52: Situation for hypertension R/ is no
Page 53 and 54: Awareness, Treatment, and Control o
Page 55 and 56: Poor Blood Pressure Control is Scot
Page 57 and 58: MR FIT: CHD Deaths Associated with
Page 59 and 60: Is there really change in clinical
Page 61 and 62: • As being very much COURAGE-type
Page 65 and 66: “We, as a cardiology community, h
Page 67: Thank U 4 your attention R&M Soluti
Page 71: Question & Answer R&M Solutions www
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