- Question
- In patients with stable coronary artery disease, does adding percutaneous coronary intervention (PCI) to optimal medical therapy reduce cardiovascular events compared with optimal medical therapy alone?
- Design
- Open-label (unmasked) randomized trial of 2287 patients at 50 centers in the United States and Canada, enrolled between 1999 and 2004, with a median follow-up of 4.6 years (range 2.5 to 7.0).
- Population
- Patients with stable coronary artery disease, objective evidence of myocardial ischemia and significant coronary disease.
- Intervention
- PCI plus optimal medical therapy, consisting of intensive pharmacologic therapy and lifestyle intervention (1149 patients).
- Control
- Optimal medical therapy alone (1138 patients).
- Primary outcome
- Composite of death from any cause and nonfatal myocardial infarction.
- Results
- The 4.6-year cumulative primary-event rate was 19.0% in the PCI group and 18.5% in the medical-therapy group (HR 1.05; 95% CI 0.87 to 1.27; P=0.62). There was also no difference in the composite of death, myocardial infarction, and stroke (20.0% vs. 19.5%; HR 1.05; 95% CI 0.87 to 1.27; P=0.62).
- Conclusion
- As an initial management strategy in stable coronary artery disease, PCI added to optimal medical therapy did not reduce the risk of death, myocardial infarction, or other major cardiovascular events.
- Why it matters
- It showed that routine percutaneous revascularization in stable patients does not improve hard outcomes over intensive medical therapy, and strengthened optimal medical therapy as the foundation of initial management.
Card generated automatically with AI from the abstract of the original publication and the trial registry; every figure was checked against those sources. It may contain errors: verify the data at the source before using it for clinical decisions.
Generated on October 7, 2026