Key result
PCI shows no benefit over optimal medical therapy for death or heart failure hospitalization.
Why the study?
CABG carries significant short-term procedural risk in severe left ventricular impairment, and randomised studies assessing whether PCI provides similar clinical benefits without surgical hazards had been lacking.
Does percutaneous coronary intervention in addition to optimal medical therapy improve outcomes compared to optimal medical therapy alone in patients with ischaemic left ventricular dysfunction and stable coronary artery disease?
Does percutaneous coronary intervention in addition to optimal medical therapy improve outcomes compared to optimal medical therapy alone in patients with ischaemic left ventricular dysfunction and stable coronary artery disease?
Effect estimate: HR 0.99 (95% CI 0.78-1.27)
Absolute Event Rate: 37% vs 38%
p-value: p=0.96
This review highlights that percutaneous coronary intervention does not improve survival or reduce heart failure hospitalizations compared to optimal medical therapy alone in patients with severe ischemic cardiomyopathy.
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PCI addition does not support routine use to reduce death or HF hospitalization in ischemic cardiomyopathy; leaves open quality-of-life effects.
Wa et al. (2023) conducted a review in Ischaemic cardiomyopathy (n=700). Percutaneous coronary intervention (PCI) vs. Optimal medical therapy was evaluated on All-cause death or hospitalisation for heart failure (HR 0.99, 95% CI 0.78-1.27, p=0.96). Percutaneous coronary intervention in addition to optimal medical therapy did not reduce all-cause death or heart failure hospitalization compared to medical therapy alone (HR 0.99).
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