Optimal medical therapy with or without PCI for stable coronary disease

Abstract (PubMed)

In patients with stable coronary artery disease, it remains unclear whether an initial management strategy of percutaneous coronary intervention (PCI) with optimal medical therapy is superior to optimal medical therapy alone. We conducted a randomized trial involving 2287 patients who had objective evidence of myocardial ischemia and significant coronary artery disease at 50 U.S. and Canadian centers. Patients were assigned to PCI plus optimal medical therapy or optimal medical therapy alone. The primary outcome was death from any cause and nonfatal myocardial infarction during a median follow-up of 4.6 years. The 4.6-year cumulative primary-event rates were 19.0% in the PCI group and 18.5% in the medical-therapy group (HR 1.05; 95% CI 0.87-1.27; P=0.62). PCI was not superior to optimal medical therapy for reducing death or nonfatal myocardial infarction in stable coronary artery disease.