Why percutaneous revascularisation might not reduce the risk of myocardial infarction and mortality in patients with stable CAD?

Open Heart. 2023 Oct;10(2):e002343. doi: 10.1136/openhrt-2023-002343.

Abstract

Percutaneous coronary intervention (PCI) is widely adopted to treat chronic coronary artery disease. Numerous randomised trials have been conducted to test whether PCI may provide any prognostic advantage over oral medical therapy (OMT) alone, without definitive results. This has maintained the paradigm of OMT as the first-line standard of care for patients, reserving PCI for symptom control. In this review, we discuss the current evidence in favour and against PCI in stable coronary syndromes and highlight the pitfalls of the available studies. We offer a critical appraisal of the possible reasons why the existing data does not provide evidence supporting the role of PCI in improving clinical outcomes in patients with stable coronary syndromes.

Keywords: CORONARY ARTERY DISEASE; Percutaneous Coronary Intervention; STABLE ANGINA.

Publication types

  • Review

MeSH terms

  • Coronary Artery Disease* / diagnosis
  • Coronary Artery Disease* / therapy
  • Humans
  • Myocardial Infarction*
  • Myocardial Ischemia*
  • Percutaneous Coronary Intervention*
  • Treatment Outcome