Pairing medical therapy with coronary intervention fails to reduce heart disease deaths

Percutaneous coronary interventions (PCI) involve opening partially blocked arteries to improve blood flow to the heart. These procedures are performed more than 1 million times a year. Since the introduction of PCI more than 30 years ago, there have been enormous advances in the understanding and medical treatment of coronary artery disease. While PCI is known to improve survival when done to restore blood flow in a heart attack, no study has examined the ability of PCI to improve outcomes over and above modern, optimal medical therapy (OMT) in patients with stable coronary disease.

Results of research presented today at the American College of Cardiologys 56th Annual Scientific Session showed that PCI combined with OMT was no more effective than OMT alone in preventing heart attacks and other cardiac events among patients with coronary artery disease. The study will be simultaneously published in the New England Journal of Medicine and will appear in the April 12 print issue. ACC.07 is the premier cardiovascular medical meeting, bringing together cardiologists and cardiovascular specialists to further breakthroughs in cardiovascular medicine.

During PCI, a doctor inserts a catheter into an artery in a patients arm or leg and advances the catheter into the coronary arteries where a balloon is inflated to clear the blockage. Usually, a stent (small, lattice-shaped, metal tube) is implanted into an artery to help keep it open. The Clinical Outcomes Utilizing Revascularization and Aggressive DruG Evaluation (COURAGE) trial enrolled 2,287 patients at 50 hospitals in the United States and Canada, randomizing them to one of two study arms: PCI and OMT together or OMT alone. Enrolled patients suffered from chronic chest pain (angina pectoris) and had at least a 70 percent blockage of one or more coronary arteries.

Both groups of patients received OMT, which includes guideline-driven intensive treatment with medicines such as aspirin, s

Contact: Leslie Humbel
American College of Cardiology

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