Meta-Analysis of Percutaneous Coronary Intervention in Stable Angina — A Contrast with COURAGE

In pooled results from 17 randomized trials, PCI was associated with a survival advantage compared with medical therapy.

The use of percutaneous coronary intervention in patients with chronic stable angina came under scrutiny with the publication of the COURAGE trial results (JW Cardiol Mar 26 2007). To improve study power to assess long-term survival, these investigators performed a meta-analysis of 17 randomized trials (including COURAGE), in which patients with ischemia but without acute coronary syndromes were treated with PCI or with medical therapy and were assessed for all-cause mortality.

The meta-analysis included 7513 patients; average follow-up was 51 months. In the PCI group, 43% of patients underwent balloon angioplasty alone, and 41% received at least one stent (predominantly bare-metal). In the medical-therapy groups, 28% of patients underwent n…

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