Stenting vs. Medical Management of Stable Coronary Disease: More Outcomes from COURAGE

In the landmark COURAGE trial, percutaneous coronary intervention (PCI; usually stenting) — added to optimal medical therapy — did not lower rates of death or myocardial infarction, compared with optimal medical therapy alone in 2287 patients with stable coronary artery disease (JW Mar 29 2007). Now, the COURAGE researchers report on symptoms and quality of life in this cohort during 3 years of follow-up.

Patients in both groups improved during the first year, but a significantly larger proportion of PCI patients than medical-therapy patients became angina-free (e.g., 56% vs. 47% at 6 months). However, between-group differences narrowed by 2 years and were no longer significant by 3 years. Similar patterns were noted for angina-symptom and q…