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A meta-analysis of randomized controlled trials comparing percutaneous coronary intervention with optimal medical

Tsahi T Lerman1,2,3, Guy Witberg2,3, Ran Kornowski2,3

  • 1Department of Internal Medicine F-Recanati, Beilinson Hospital, Rabin Medical Center.

Coronary Artery Disease
|February 3, 2021
PubMed

Insights

For stable obstructive coronary artery disease (SOCAD), percutaneous coronary intervention (PCI) plus optimal medical therapy (OMT) offers no significant benefit over OMT alone for mortality or myocardial infarction. This finding impacts clinical management decisions for SOCAD patients.

Area of Science:

  • Cardiology
  • Interventional Cardiology
  • Clinical Trials

Background:

  • Optimal treatment for stable obstructive coronary artery disease (SOCAD) remains debated.
  • Previous studies have not demonstrated improved outcomes with percutaneous coronary intervention (PCI) alongside optimal medical therapy (OMT).

Purpose of the Study:

  • To evaluate the added value of PCI plus OMT compared to OMT alone in patients with SOCAD.
  • To assess the impact on cardiovascular outcomes.

Main Methods:

  • Systematic search and meta-analysis of randomized controlled trials.
  • Included six trials with 11,144 patients and follow-up periods ranging from 2.2 to 11.4 years.

Main Results:

  • No significant difference in all-cause mortality (OR = 0.98, P = 0.79) between PCI + OMT and OMT alone.
  • No significant difference in cardiovascular mortality (OR = 0.91, P = 0.27) or myocardial infarction (OR = 0.92, P = 0.18).

Conclusions:

  • Performing PCI in addition to OMT does not improve cardiovascular outcomes for SOCAD patients.
  • Findings suggest OMT alone may be sufficient for managing SOCAD, warranting consideration in treatment guidelines.
Abstract

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