Percutaneous coronary intervention plus guideline-directed medical therapy (GDMT) versus GDMT alone in adults with stable coronary artery disease

Arturo J Martí-Carvajal; Mark Dayer; Diana Monge Martín; Mario A Gemmato-Valecillos; Gabriella Comunián-Carrasco; Ricardo Riera Lizardo; Iván Pérez‐Neri; Irshad Ali Bajeer; Bhone Myint Kyaw; Mona Abdalla; Raquel Esther Gonzalez Hormostay; Cristina Elena Martí-Amarista; Gursimer Jeet; José Miguel Palacios; Fernando-María Caballero -Martínez

doi:10.1002/14651858.cd016213

January 19, 2026Cochrane libraryOpen Access

Percutaneous coronary intervention plus guideline-directed medical therapy (GDMT) versus GDMT alone in adults with stable coronary artery disease

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Why the study?

To evaluate the clinical benefits and harms of percutaneous coronary intervention plus guideline-directed medical therapy compared with guideline-directed medical therapy alone for stable coronary artery disease in adults.

Does percutaneous coronary intervention plus guideline-directed medical therapy improve clinical outcomes and quality of life compared to guideline-directed medical therapy alone in adults with stable coronary artery disease?

Key Points

To evaluate the clinical benefits and harms of percutaneous coronary intervention added to guideline-directed medical therapy compared with guideline-directed medical therapy alone in adults with stable coronary artery disease.
Protocol for a Cochrane systematic review evaluating randomized clinical trials comparing percutaneous coronary intervention plus guideline-directed medical therapy against medical therapy alone.
Outcomes predefined for assessment include overall survival, cardiovascular mortality, health-related quality of life, major bleeding, and angina relief across follow-up intervals from 30 days to 5 years.
Analytical framework incorporates the cross-over ratio of participants transitioning from medical therapy to intervention to adjust efficacy estimates and evaluate treatment durability.
Proposed minimal clinically important differences require an absolute reduction of ≥ 1.5% to 2% for cardiovascular mortality and ≥ 2% to 3% for non-fatal myocardial infarction.
Trial threshold criteria designate a relative risk reduction of ≥ 20% for urgent revascularisation and an acceptable absolute increase of ≤ 1% for severe bleeding.

Structured PICO

Does percutaneous coronary intervention plus guideline-directed medical therapy improve clinical outcomes and quality of life compared to guideline-directed medical therapy alone in adults with stable coronary artery disease?

P

Population

Adults (≥ 18 years) with stable coronary artery disease (documented coronary artery stenosis ≥ 50% in at least one major epicardial vessel; typical angina or evidence of ischaemia; no acute coronary syndrome within 30 days, prior CABG, cardiogenic shock, or prior incomplete revascularization).

I

Intervention

Percutaneous coronary intervention (balloon angioplasty, bare-metal stents, drug-eluting stents, or bioresorbable vascular scaffolds) plus guideline-directed medical therapy (GDMT).

C

Comparator

Guideline-directed medical therapy (GDMT) alone (antiplatelet therapy, lipid-lowering therapy, blood pressure control, diabetes management, angina relief, and lifestyle modifications).

O

Outcome

Overall survival, quality of life, all-cause cardiovascular mortality, serious adverse events, symptom relief (angina), total myocardial infarction, repeat revascularisation, and left ventricular function.

This is a Cochrane systematic review protocol designed to evaluate the clinical benefits and harms of PCI combined with GDMT versus GDMT alone for the management of stable coronary artery disease.

Limitations

Will not specifically search for observational studies to include in the review, potentially missing observational evidence for adverse events.

Ask about this paper

Answers are grounded in this paper and cite their sources.

Implication

Protocol for PCI + GDMT vs GDMT alone in stable CAD; leaves optimal revascularization strategy open pending completion.

Abstract

OBJECTIVES: This is a protocol for a Cochrane Review (intervention). The objectives are as follows: To evaluate the clinical benefits and harms of percutaneous coronary intervention plus guideline-directed medical therapy compared with guideline-directed medical therapy alone for stable coronary artery disease in adults.

Discussion

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Cite This Study

Martí-Carvajal et al. (2026) studied this question.

synapsesocial.com/papers/6a7cc217bc7a4688beba4864 https://doi.org/10.1002/14651858.cd016213

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Percutaneous coronary intervention plus guideline-directed medical therapy (GDMT) versus GDMT alone in adults with stable coronary artery disease

Key Points

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

Percutaneous coronary intervention plus guideline-directed medical therapy (GDMT) versus GDMT alone in adults with stable coronary artery disease

Key Points

Structured PICO

Limitations

Ask about this paper

Implication

Abstract

Discussion

Cite This Study

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