Exercise Time After Percutaneous Coronary Intervention for Angina

HealthDay News — 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 in The Lancet.

Rasha Al-Lamee, MRCP, from Imperial College London, and colleagues enrolled patients with stable angina and severe (≥70%) 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 4 pressure-wire-related complications in the placebo group that required PCI and 5 major bleeding events (2 in the PCI group and 3 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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Al-Lamee R, Thompson D, Dehbi HM, et al. Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial. Lancet. 2017 Nov 1. pii: S0140-6736(17)32714-9.