In this trial patients with documented coronary artery disease and an objective proof of lack of blood flow to an area of their hearts were assigned to one of to treatment strategies. One group underwent cardiac catheterization and the artery that was obstructed was opened with an angioplasty procedure. These patient's were later on placed on intensive medical regimen to control the blood pressure, diabetes, cholesterol as well as to quit smoking and lose weight. The second group of patients were only offered the intensive medical therapy program along with support to quit smoking and lose weight.
Both group of patients were followed for over 4 years and their cardiovascular health was assessed during subsequent visits. At the end of the follow-up period the group of patients that received angioplasty procedure did not do better in terms of repeat myocardial infarctions or cardiovascular death when compared to the group of patients that received only medical therapy.
In the group of patients that only received medical therapy approximately 30% underwent an angioplasty procedure in order to control their symptoms at a later time .
These trial proves that an initial strategy of aggressive medical therapy and risk factor modification is absolutely safe in those patients with documented coronary artery disease. If despite medical therapy the symptoms persist , then proceeding with an angioplasty is also a reasonable alternative.
