- Question
- Does percutaneous coronary intervention (PCI) relieve stable angina more than a placebo procedure in patients who are not receiving antianginal medication?
- Design
- Double-blind, randomized, placebo-controlled trial with 1:1 assignment to PCI or a placebo procedure and 12 weeks of follow-up. Before randomization, patients stopped all antianginal medications and completed a 2-week symptom assessment phase. A total of 301 patients were randomized.
- Population
- Patients with stable angina and objective evidence of ischemia who were receiving little or no antianginal medication. Mean age was 64 years and 79% were men; ischemia involved a single cardiac territory in 80%.
- Intervention
- Percutaneous coronary intervention of the ischemia-related target vessel (151 patients).
- Control
- Placebo procedure (150 patients).
- Primary outcome
- Angina symptom score, calculated daily from the number of angina episodes, the number of antianginal medications prescribed that day, and clinical events (unblinding due to unacceptable angina, acute coronary syndrome, or death); range 0 to 79, with higher scores indicating worse health status.
- Results
- At 12 weeks, the mean angina symptom score was 2.9 in the PCI group and 5.6 in the placebo group (odds ratio 2.21; 95% CI 1.41 to 3.47; P<0.001).
- Safety
- One patient in the placebo group had unacceptable angina leading to unblinding. Acute coronary syndromes occurred in 4 patients in the PCI group and 6 in the placebo group.
- Conclusion
- In patients with stable angina and evidence of ischemia who were receiving little or no antianginal medication, PCI produced a lower angina symptom score than a placebo procedure.
- Why it matters
- It provided placebo-controlled evidence that PCI relieves angina beyond the placebo effect when assessed off background antianginal therapy, helping to define the role of PCI in the symptomatic management of stable angina.
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 14, 2026