Presentatie - vzw farmaka asbl

4b.Bates. EBM 2001;6:13. Commentary on: Bucher. BMJ 2000;321:73-7
Design N/n Population Sd Interventions Outcomes Results
MA N=6,
n=1904
-PTCA
-Medication only
Angina at the
end of study
-Stable angina
pectoris
-59%: history of acute
myocardial infarction
(MI)
-No acute MI in
previous week
-3 RCTs: patients
without symptomatic
angina
-Stents in a minority
of patients only in 1
study
6 to
57
m
PTCA vs enkel medicatie
-53% (PTCA) vs 70%
-RRR= 30% (95%CI 2 to 50)
-NNT= 6 (95%CI 3 to 637)
Mortality -15 deaths (PTCA) vs 11
-RR= 1.32 (95%CI 0.65 to 2.70) in favour
of medication
Non-fatal MI -41 MI’s (PTCA) vs 29
-RR=1.42 (95%CI 0.9 to 2.25)
CABG (Coronary -7.6% (PTCA) vs 4.1%
Artery Bypass -RRI= 59% (95%CI 9 to 132)
Grafting) -NNH= 29 (95%CI 19 to 66)
Need for PTCA -RR=1.29 (95%CI 0.71 to 3.36)
- 52.Boden. COURAGE trial. NEJM 2007;356:1503-16
- Schröder. De plaats van coronaire angioplastiek bij stabiele angor. Minerva 2007;6(10):152-3 (NL). Minerva 2008;7(1):2-3
(FR). Commentary on Boden. NEJM 2007;356:1503-16
Design n Population Sd Interventions Outcomes Results
RCT 2287 -Coronary artery
disease (with or
without angina
symptoms)
5y -PTCA (+/-
stent, usually
bare-metal) +
medication
-Medication only
(92% statins;
84% β-blocker;
72% ACE-I or
sartans)
Primary outcome
Mortality OR Nonfatal
MI
-19% (PTCA) vs 18.5%
-RR= 1.05 (95%CI 0.87 to 1.27)
-Mortality: 1.7% in both groups
Secondary outcomes
Mortality, MI, stroke -RR=1.05 (95%CI 0.87 to 1.27)
Hospitalisation for -RR= 1.07 (95%CI 0.84 to 1.37)
unstable angina
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