TAILIEUCHUNG - Optimal Medical Therapy with or without PCI for Stable Coronary Disease

In patients with stable coronary artery disease, it remains unclear whether an initial management strategy of percutaneous coronary intervention (PCI) with intensive pharmacologic therapy and lifestyle intervention (optimal medical therapy) is superior to optimal medical therapy alone in reducing the risk of cardiovascular events. Methods We conducted a randomized trial involving 2287 patients who had objective evidence of myocardial ischemia and significant coronary artery disease at 50 . and Canadian centers | Optimal Medical Therapy with or without PCI for Stable Coronary Disease Optimal Medical Therapy with or without PCI for Stable Coronary Disease William E. Boden . Robert A. O Rourke . Koon K. Teo . . . Pamela M. Hartigan . David J. Maron . William J. Kostuk . Merril Knudtson . Marcin Dada . Paul Casperson . Crystal L. Harris . Bernard R. Chaitman . Leslee Shaw . Gilbert Gosselin . Shah Nawaz . Lawrence M. Title . Gerald Gau . Alvin S. Blaustein . David C. Booth . Eric R. Bates . John A. Spertus . . Daniel S. Berman . . John Mancini . and William S. Weintraub . for the COURAGE Trial Research Group abstract background In patients with stable coronary artery disease it remains unclear whether an initial management strategy of percutaneous coronary intervention PCI with intensive pharmacologic therapy and lifestyle intervention optimal medical therapy is superior to optimal medical therapy alone in reducing the risk of cardiovascular events. methods We conducted a randomized trial involving 2287 patients who had objective evidence of myocardial ischemia and significant coronary artery disease at 50 . and Canadian centers. Between 1999 and 2004 we assigned 1149 patients to undergo PCI with optimal medical therapy PCI group and 1138 to receive optimal medical therapy alone medical-therapy group . The primary outcome was death from any cause and nonfatal myocardial infarction during a follow-up period of to years median . results There were 211 primary events in the PCI group and 202 events in the medicaltherapy group. The cumulative primary-event rates were in the PCI group and in the medical-therapy group hazard ratio for the PCI group I. 05 95 confidence interval CI to P . There were no significant differences between the PCI group and the medical-therapy group in the composite of death myocardial infarction and stroke vs. .

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