PHILADELPHIA — Percutaneous coronary intervention (PCI) in patients with stable coronary artery disease (CAD) reduces angina frequency, increases exercise capacity, and improves quality of life, results of a placebo-controlled, randomized trial show, confirming advantages that have never before been proven.
"The effect of PCI was immediate, sustained over 12 weeks, and consistent across all endpoints," reported Christopher A. Rajkumar, MBBS, an interventional cardiology registrar at the Imperial College Healthcare Trust, London, UK.
Results of the trial, ORBITA-2, were presented today here at the American Heart Association Scientific Sessions 2023, and simultaneously published online in the New England Journal of Medicine.
Symptom relief has long been a justification for PCI in patients with stable CAD, but the evidence has been derived from uncontrolled studies, Rajkumar said. However, the first ORBITA trial, which was also placebo-controlled and randomized, failed to show benefit.
Rajkumar acknowledged that the benefit of PCI in ORBITA-2 was lower than previously reported in nonrandomized trials. He also noted that 59% of patients still had at least some angina symptoms following PCI.
Even though ORBITA-2 proves that PCI is better than no PCI, he agreed that well-informed patients, such as those who wish to avoid an invasive procedure, might still reasonably select antianginal medication over PCI.
