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PCI Does Not Improve Exercise Time in Angina Patients

MONDAY, Nov. 6, 2017 -- Percutaneous coronary intervention (PCI) does not increase exercise time more than a placebo procedure in patients with medically treated angina and severe coronary stenosis, according to a study published online Nov. 2 in The Lancet.

Rasha Al-Lamee, M.R.C.P., from Imperial College London, and colleagues enrolled patients with stable angina and severe (≥70 percent) single-vessel stenosis. Cardiopulmonary exercise testing, symptom questionnaires, and dobutamine stress echocardiography were conducted, and patients were randomized to undergo PCI (n = 105) or a placebo procedure (n = 95).

The researchers found that there was no significant difference in the primary endpoint of exercise time increment between groups. No deaths were reported over the study period, but serious adverse events included four pressure-wire-related complications in the placebo group that required PCI and five major bleeding events (two in the PCI group and three in the placebo group).

"In patients with medically treated angina and severe coronary stenosis, PCI did not increase exercise time by more than the effect of a placebo procedure. The efficacy of invasive procedures can be assessed with a placebo control, as is standard for pharmacotherapy," write the authors.

Several authors disclosed financial ties to Philips Volcano, which supplied the coronary pressure wires for the study.

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Posted: November 2017