PCI equals OMT

Improved medical therapy equals Percutaneous Coronary Intervention (PCI) for angina relief in patients with stable Coronary Artery Disease.

In five trials published since 2000, 77% of patients were angina free after PCI, vs. 75% on medical therapy alone, an insignificant difference. Optimal medical therapy (used as a proxy for the aggressiveness of overall medical therapy included:

• Aspirin
• β-blockers
• ACE Inhibitors
• Statins

Conclusions:

• Since PCI in stable coronary artery disease (CAD) is no better than medical therapy in improving the incidence of myocardial infarction (MI) or death, its only indication is relief of angina.
• PCI does not provide better symptom relief than optimal medical therapy.
• These findings emphasize the need to optimize medical therapy before referring patients for PCI.

(From: Wijeysundera HC et al. Meta-analysis: Effects of percutaneous coronary intervention versus medical therapy on angina relief. Ann Intern Med 2010 Mar 16; 152:370)