C-46 | Percutaneous Coronary Intervention for Stable Coronary Artery Disease: An Updated Meta-analysis

Guidelines recommend percutaneous coronary intervention (PCI) for symptom control in patients with stable coronary artery disease (CAD), with the studies showing variable results in terms of cardiovascular (CV) outcomes. We conducted an updated meta-analysis to reconcile the data. Online databases were searched for randomized controlled trials (RCTs) comparing PCI to control (medical therapy, exercise training or placebo) in patients with stable CAD. The outcomes of interest were death, myocardial infarction (MI) and stroke. Pooled odds ratios (OR) and 95% confidence intervals (CI) were calculated using a random-effects model. Thirteen RCTs with a total of 8,241 patients (PCI n=4,192, control n=4,049) were included. The mean age was 63 years, 80% patients were men, 66% had hypertension, 31% had diabetes, 75% had hyperlipidemia, 26% were smokers and 13.6% had triple vessel disease. The mean duration of follow up was 37 months. No significant difference was found between the PCI and control groups with respect to death (OR 0.94, 95% CI 0.79 to 1.10, p = 0.43), MI (OR 0.89, 95% CI 0.69 to 1.16, p = 0.39) (figure) or stroke (OR 1.20, 95% CI 0.85 to 1.68, p = 0.30). In patients with stable CAD, PCI is associated with similar CV outcomes when compared with control.