PCI Not Effective in Stable Angina

A blinded, multicenter randomized trial of percutaneous coronary intervention (PCI) versus a sham procedure for angina relief in the UK revealed that in patients with medically treated angina and severe coronary stenosis, PCI did not increase exercise time or improve symptoms. 230 patients with ischemic symptoms and severe (≥70%) single-vessel stenosis were enrolled and received 6 weeks of medication optimization, 200 patients underwent randomization between Jan 6, 2014, and Aug 11, 2017. Lesions had mean area stenosis of 84·4%, fractional flow reserve of 0·69, and instantaneous wave-free ratio of 0·76. There was no significant difference in the primary endpoint of exercise time increment between groups (PCI minus placebo 16·6 s, 95% CI −8·9 to 42·0, p=0·200). The results are consistent with previous findings that PCI in stable lesions did not produce long-term improvements in outcome when compared to optimal medical therapy. PCI has been proven effective in acute coronary syndrome. Source: http://www.thelancet.com/