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Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
10:28

Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function

Published on: March 15, 2022

A meta-analysis of 17 randomized trials of a percutaneous coronary intervention-based strategy in patients with

Albert Schömig1, Julinda Mehilli, Antoinette de Waha

  • 1Deutsches Herzzentrum München, Technische Universität, Munich, Germany. aschoemig@dhm.mhn.de

Journal of the American College of Cardiology
|September 6, 2008
PubMed

Insights

Percutaneous coronary intervention (PCI) may improve long-term survival for stable coronary artery disease patients compared to medical treatment alone. This invasive strategy showed a reduced risk of all-cause death in a meta-analysis of randomized trials.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Trials

Background:

  • The long-term prognostic impact of percutaneous coronary intervention (PCI) in stable coronary artery disease (CAD) remains uncertain.
  • Existing evidence does not definitively establish the benefits of an invasive PCI strategy over optimal medical therapy for patients with stable ischemic heart disease.

Purpose of the Study:

  • To evaluate the effect of percutaneous coronary intervention (PCI) compared to medical treatment on long-term mortality.
  • To assess the impact of an invasive PCI strategy versus a conservative medical approach in patients presenting with symptoms of myocardial ischemia but without acute coronary syndrome.

Main Methods:

  • A meta-analysis of 17 randomized controlled trials involving 7,513 patients with stable coronary artery disease.
  • Comparison of a PCI-based invasive strategy against a medical treatment-only strategy.
  • Primary endpoint was all-cause mortality, with an average follow-up of 51 months.

Main Results:

  • Percutaneous coronary intervention (PCI) was associated with a 20% reduction in the odds ratio of all-cause death (OR: 0.80; 95% CI: 0.64 to 0.99).
  • A nonsignificant 26% reduction in cardiac death was observed with PCI (OR: 0.74; 95% CI: 0.51 to 1.06).
  • Rates of nonfatal myocardial infarction were similar between the PCI and medical treatment groups (OR: 0.90; 95% CI: 0.66 to 1.23).

Conclusions:

  • An invasive strategy utilizing percutaneous coronary intervention (PCI) may enhance long-term survival in patients with stable coronary artery disease.
  • These findings suggest that PCI could be a beneficial treatment option for selected patients with stable ischemic heart disease.
Abstract

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