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Updated: Jun 14, 2025
Interventional Diagnostic Procedure: A Practical Guide for the Assessment of Coronary Vascular Function
Published on: March 15, 2022
Comparative Effectiveness of Interventional Therapy versus Exercise Rehabilitation in Stable Angina Patients with
Yucheng Wu1, Jie Qiu1, Xiang Sha1
1Department of Cardiology, Taizhou School of Clinical Medicine, Nanjing Medical University, The Affiliated Taizhou People's Hospital of Nanjing Medical University, Taizhou, Jiangsu Province, 225300, People's Republic of China.
Insights
For stable angina with severe stenosis, percutaneous coronary intervention (PCI) did not reduce cardiovascular events more than exercise-based cardiac rehabilitation (CR). However, CR significantly improved cardiovascular fitness and quality of life.
Area of Science:
- Cardiology
- Interventional Cardiology
- Rehabilitation Medicine
Background:
- Stable angina management includes pharmacotherapy, revascularization, and cardiac rehabilitation (CR).
- Optimal treatment for severe coronary artery stenosis in stable angina remains unclear.
- This study compared interventional therapy versus exercise rehabilitation.
Purpose of the Study:
- To compare the efficacy of percutaneous coronary intervention (PCI) plus optimal medical therapy (OMT) versus OMT plus CR in stable angina patients with severe coronary stenosis.
- To evaluate cardiovascular composite endpoint events, cardiopulmonary fitness, and quality of life.
Main Methods:
- Fifty patients received OMT plus PCI (stent implantation).
- Fifty patients received OMT plus CR with exercise rehabilitation guidance for one year.
- Outcomes assessed included cardiovascular events, peak VO2, peak load, anaerobic threshold (AT), and quality of life scores.
Main Results:
- No significant difference in cardiovascular composite endpoint events between OMT+PCI and OMT+CR groups (20.0% vs 14.6%).
- Cardiopulmonary fitness (peak VO2, peak load, AT) was significantly higher in the OMT+CR group.
- Both groups improved quality of life, with greater improvements in more scales for the OMT+CR group.
Conclusions:
- Interventional therapy (PCI) did not confer a greater reduction in cardiovascular events compared to exercise-based CR.
- Exercise-based CR demonstrated superior improvements in cardiovascular fitness and quality of life.
- CR is a viable and potentially more beneficial alternative for managing stable angina with severe coronary stenosis.
Background:
Management strategies for stable angina include pharmacotherapy, revascularization, and exercise-based cardiac rehabilitation (CR). The optimal treatment for stable angina patients with severe coronary artery stenosis remains unclear. This study aimed to compare interventional therapy with exercise rehabilitation in this population.
Methods:
Fifty stable angina patients with severe coronary stenosis who underwent stent implantation were included in the optimal medical therapy (OMT) plus percutaneous coronary intervention (PCI) group, and 50 patients who did not undergo interventional treatment were included in OMT plus CR group receiving exercise rehabilitation guidance for one year. Cardiovascular composite endpoint events, cardiopulmonary fitness, and quality of life scale scores were assessed after one year.
Results:
No significant difference in incidence of cardiovascular composite endpoint events was observed between OMT plus PCI group with OMT plus CR group (20.0% vs 14.6%) after one year. Cardiopulmonary fitness represented as peak VO2 (19.2±3.5 vs 17.6±3.2 mL/kg/min), peak load (120±19 vs 108±20 W), and AT (13.5±1.5 vs 12.1±1.3 mL/kg/min) were significantly higher in the rehabilitation group than the intervention group after one year. Both groups showed improvement in their quality of life, but the rehabilitation group improved in more scales.
Conclusion:
Interventional therapy did not reduce cardiovascular events compared to exercise-based rehabilitation in stable angina patients with severe coronary artery stenosis, but the rehabilitation can improve cardiovascular fitness and quality of life more.
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