14. PTCA versus PCI (Stent) - Take 2

Unfortunately, despite the really cool names, and the really great study design, and 10,347 patients, there was NO significant difference observed between the stent group and PTCA group in the rates of death or myocardial infarction. There was a difference in the number of people who needed a subsequent PTCA, but that is not a great result. "We found that there was no benefit to treatment A over treatment B, but we did find that if you get treatment A, we need to do it again." Twenty-three negative studies? I would have given up.

Al Suwaidi J, Holmes DR Jr, Salam AM, Lennon R, Berger PB.
Am Heart J. 2004 May;147(5):815-22.

	23 trials which received anti-platelet therapy
	10,347 patients
	5130 patients randomized to receive stent
	5217 patients randomized to receive balloon angioplasty
	902 (17 %) of patients crossed over from a strategy of balloon angioplasty to stent placement because of the inability to achieve a satisfactory result with a balloon.
	No significant difference was observed between the stent group and PTCA group in the rates of death or myocardial infarction
	Significant reduction in target vessel revascularization (odds ratio, 0.59; 95% CI, 0.50-0.70; P <.001)