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(Circulation. 2002;106:e9029.)
© 2002 American Heart Association, Inc.

Cardiovascular News

Ruth SoRelle, MPH

Circulation Newswriter

An extract of the first 250 words of the full text is provided, because this article has no abstract.

Recent Clinical Trial Updates

BERLIN, Germany—One year into the Trial of Medical Therapy versus Invasive in the Elderly (TIME), improvements in angina and measures of quality of life previously seen in older patients who had been randomized to receive either optimal anti-ischemic drug therapy or revascularization by either percutaneous intervention or coronary artery bypass graft continued. However, larger benefits noted at 6 months in the revascularized group disappeared at 12 months.

The reason, however, according to Dr Matthias Pfisterer of the University Hospital in Basel, Switzerland, was that 46% of patients in the medical group underwent a revascularization period in that later period. The remaining patients, he said, had more angina and lower quality-of-life scores than those in the original revascularized group. (Eleven percent of the invasively treated group also underwent a further revascularization.)

The study involved 301 patients who had been randomized to either the medical treatment or angiography and revascularization if needed. In that group, 70% of patients underwent PCI and 30% coronary artery bypass grafting. In the earlier analysis, patients who had revascularization had higher mortality rates (although they were not statistically significant), said Dr Pfisterer. However, the 1-year mortality rates were essentially the same. "The overall benefits outweighed the early risks of revascularization," he said. He said patients aged >75 years should probably be offered an evaluation for revascularization treatment just as younger ones are.

In the Prevention of Atrial Fibrillation After Cardioversion (PAFAC) trial, Thomas Fetsch, MD, of the University of Münster in Germany, said the intent was to . . . [Full Text of this Article]