Key result
Percutaneous coronary intervention does not confer clear benefit for mortality, myocardial infarction, or revascularization compared to medical conservative treatment in stable CAD.
Why the study?
Does percutaneous coronary intervention improve hard long-term clinical outcomes in patients with chronic coronary artery disease and good left ventricular function compared to medical conservative treatment?
Does percutaneous coronary intervention improve hard long-term clinical outcomes in patients with chronic coronary artery disease and good left ventricular function compared to medical conservative treatment?
In patients with stable CAD and good LV function, PCI does not improve hard clinical outcomes compared to conservative medical therapy, questioning the justification of many non-acute interventions.
May support medical therapy first in stable CAD with preserved LV function; leaves open need for updated RCTs in higher-risk groups.
A review of the existing evidence on the impact of percutaneous coronary intervention (PCI) in the setting of stable coronary artery disease (CAD) indicates that in patients with chronic coronary artery disease and good left ventricular function, PCI does not confer any clear benefit in terms of hard long-term clinical outcomes, such as mortality, myocardial infarction or the need for subsequent revascularization, as compared with medical conservative treatment. By comparing the benefits against cost considerations, it seems that many percutaneous interventions that are currently performed in patients with non-acute CAD are probably not justified. Determination of the functional significance of coronary artery disease can often be a challenge. Conventional coronary angiography and imaging tests, although suitable for risk stratification, may not be satisfactory as independent guides for specific decision-making regarding the optimum management of these patients. The development of more efficient methods for the identification of coronary lesions that should be the target of coronary intervention is certainly needed.
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Demosthenes G. Katritsis (2007) conducted a review in Stable coronary artery disease (CAD). Percutaneous coronary intervention (PCI) vs. Medical conservative treatment was evaluated on Hard long-term clinical outcomes, such as mortality, myocardial infarction or the need for subsequent revascularization. Percutaneous coronary intervention does not confer clear benefit for mortality, myocardial infarction, or revascularization compared to medical conservative treatment in stable CAD.
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