June 3, 2009Circulation Cardiovascular Quality and Outcomes
Quantitative Results of Baseline Angiography and Percutaneous Coronary Intervention in the COURAGE Trial
Key result
Percutaneous coronary intervention plus optimal medical therapy achieved 93% quantitative angiographic success but yielded similar overall event rates compared to optimal medical therapy alone.
Why the study?
Does angiographic burden or completeness of revascularization alter the comparative effectiveness of PCI plus optimal medical therapy versus optimal medical therapy alone in stable coronary patients?
Population
Stable coronary patients from the COURAGE trial across Veterans Administration, US non-Veterans…
Comparison
Optimal medical therapy plus percutaneous… vs Optimal medical therapy alone
Design
RCT, randomized
Authors
Discussion
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Member takes
Implication
Greater angiographic burden does not identify PCI beneficiaries in stable CAD; confirms OMT sufficiency irrespective of lesion complexity.
Study Design
Type
RCT
Multicenter
Yes
Structured PICO
Does angiographic burden or completeness of revascularization alter the comparative effectiveness of PCI plus optimal medical therapy versus optimal medical therapy alone in stable coronary patients?
P
Population
Stable coronary patients from the COURAGE trial across Veterans Administration, US non-Veterans Administration, and Canada health care systems.
I
Intervention
Optimal medical therapy plus percutaneous coronary intervention (PCI)
C
Comparator
Optimal medical therapy alone
O
Outcome
Angiographic success (visual and quantitative), completeness of revascularization, and clinical event rates (death or nonfatal myocardial infarction)surrogate
In patients with stable coronary artery disease, greater angiographic burden predicts higher overall event rates but does not identify a subgroup that benefits more from an initial strategy of PCI added to optimal medical therapy.
Cite This Study
Mancini et al. (2009) conducted an RCT in Stable coronary disease. Optimal medical therapy plus percutaneous coronary intervention (PCI) vs. Optimal medical therapy alone was evaluated. Percutaneous coronary intervention plus optimal medical therapy achieved 93% quantitative angiographic success but yielded similar overall event rates compared to optimal medical therapy alone.