Percutaneous Coronary Intervention Reduces Ischemia in COURAGE Substudy

Myocardial perfusion scintigraphy measurements before and after optimal medical therapy with or without PCI suggest that residual ischemia may affect CAD prognosis.

Results of the COURAGE trial (Journal Watch Cardiology Mar 26 2007) demonstrated no difference in the rates of death or MI between patients with stable coronary artery disease treated with optimal medical therapy alone and those treated with optimal medical therapy plus percutaneous coronary intervention. In this planned substudy, 314 COURAGE participants who had been consecutively randomized to one of the two interventions at 25 of the 50 study sites underwent myocardial perfusion scintigraphy (MPS) with exercise or vasodilator stress at baseline and about 1 year after enrollment. Mean clinical follow-up was 3.6 years after the second MPS scan.

At the second MPS scan, the reduction in the number of patients with ST-segment depression was si…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI