February 11, 2008Circulation
Optimal Medical Therapy With or Without Percutaneous Coronary Intervention to Reduce Ischemic Burden
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Key result
Adding percutaneous coronary intervention to optimal medical therapy resulted in a greater reduction in ischemic myocardium (−2.7% vs. −0.5%, P <0.0001).
Why the study?
Does adding PCI to OMT reduce ischemic burden in patients with stable CAD and ischemia?
Population
Patients with medically stable coronary artery disease with ≥70% stenosis in at least 1 major epicardial…
Comparison
Percutaneous coronary intervention added to… vs Optimal medical therapy (OMT) alone
Design
RCT, Randomized to optimal medical therapy with or without percutaneous…
Follow-up
6 to 18 months (mean 374±50 days)
Authors
Discussion
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Implication
PCI addition to OMT yields greater ischemia reduction in stable CAD; confirms revascularization value for ischemic burden.
Structured PICO
Does adding PCI to OMT reduce ischemic burden in patients with stable CAD and ischemia?
P
Population
Patients with medically stable coronary artery disease (CAD) with ≥70% stenosis in at least 1 major epicardial coronary artery and myocardial perfusion single photon emission computed tomography (MPS) ischemia
I
Intervention
Percutaneous coronary intervention (PCI) added to optimal medical therapy (OMT)
C
Comparator
Optimal medical therapy (OMT) alone
O
Outcome
≥5% reduction in ischemic myocardium at follow-upsurrogate
In patients with stable CAD, adding PCI to optimal medical therapy resulted in a significantly greater reduction in myocardial ischemia compared to medical therapy alone.
Limitations
- Substudy sample size was not powered to examine differences in clinical outcomes
- Risk adjustment attenuated comparative differences for clinical outcomes
- Observational nature of the outcome associations
Cite This Study
Shaw et al. (2008) studied this question. Adding percutaneous coronary intervention to optimal medical therapy resulted in a greater reduction in ischemic myocardium (−2.7% vs. −0.5%, P <0.0001).
Topics
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