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The COURAGE trial generated much discussion in 2007, when its investigators presented results suggesting that, in patients with stable angina — but without high-risk disease identified by angiograms — percutaneous coronary intervention (PCI) did not lower rates of myocardial infarction or death compared with best medical therapy. In 2008, the COURAGE investigators presented data on additional important outcomes — symptom relief and quality of life (QOL).
Among 2287 patients who were randomized to PCI plus optimal medical therapy or optimal medical therapy alone, the proportion of patients who were free of angina at 3-month follow-up was significantly higher in the PCI group (53% vs. 42%), and the PCI group also had generally better angina-sp…