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March 26, 2007New England Journal of MedicineOpen Access

PCI did not reduce the risk of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy.

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Why the study?

Does PCI reduce the risk of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy in patients with stable coronary artery disease?

Population

Patients with stable coronary artery disease

Comparison

PCI added to optimal medical therapy vs Optimal medical therapy alone

Design

RCT

Authors

WBWilliam E. BodenRORobert A. O’RourkeKTKoon Teo

Discussion

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Overview

PCI adds no prognostic benefit to optimal medical therapy in stable CAD; challenges routine revascularization and reinforces medical therapy first.

Key Points

  • To assess the impact of adding percutaneous coronary intervention (PCI) to optimal medical therapy in patients with stable coronary artery disease.
  • Randomized trial design
  • Comparing outcomes between optimal medical therapy and therapy plus PCI
  • ClinicalTrials.gov number NCT00007657
  • Adding PCI did not reduce the risk of death in patients with stable coronary artery disease
  • No significant reduction in myocardial infarction was observed
  • Other major cardiovascular events remained unchanged with PCI addition

Structured PICO

Does PCI reduce the risk of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy in patients with stable coronary artery disease?

P
Population
Patients with stable coronary artery disease
I
Intervention
PCI added to optimal medical therapy
C
Comparator
Optimal medical therapy alone
O
Outcome
Death, myocardial infarction, or other major cardiovascular eventscomposite

In patients with stable coronary artery disease, an initial management strategy of PCI added to optimal medical therapy does not reduce major cardiovascular events compared to optimal medical therapy alone.

Coverage & sources

Journal, society, and media accounts. Useful signal, not independent expert judgment.

Cite This Study

Boden et al. (2007) studied this question.

synapsesocial.com/papers/699c76b8dc4c263ead9410efhttps://doi.org/10.1056/nejmoa070829
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