Nishigaki Kazuhiko
Second Department of Internal Medicine, Gifu University Graduate School of Medicine.
Nihon Rinsho. 2011 Feb;69(2):253-8.
We conducted a randomized trial in which the long-term prognoses obtained with PCI+ medical therapy (P) and Medical therapy only (M) were compared in patients with stable low-risk CAD (JSAP Study). The cumulative risk of death+ACS was significantly smaller in the P group. The incidence of ACS stemming from the PCI-target lesion was significantly lower in the P group. A considerable number of ACS cases may originate from coronary sites with already severe stenosis makes it reasonable to expect that PCI therapy would protect against a future ACS attack by stabilizing the PCI-target lesion as well as reducing stenosis. Therefore, P may improve long-term prognosis more effectively than M, which is different from the result of COURAGE Trial.
我们进行了一项随机试验，比较了稳定型低危冠心病患者接受PCI+药物治疗（P）和单纯药物治疗（M）的长期预后（JSAP研究）。P组死亡+ACS的累积风险显著更低。P组源自PCI靶病变的ACS发生率显著更低。相当一部分ACS病例可能源于已有严重狭窄的冠状动脉部位，因此有理由期望PCI治疗通过稳定PCI靶病变以及减轻狭窄来预防未来的ACS发作。因此，与COURAGE试验的结果不同，P可能比M更有效地改善长期预后。
