Stenting Does Not Relieve Stable Angina Symptoms.
Angina Symptoms Patients with stable angina who underwent percutaneous coronary intervention (PCI) had no significant symptom relief or improvement in quality of life compared with patients who had a placebo procedure, found a trial in the Lancet. The observation that PCI leads to improvement in angina symptoms may involve a large placebo effect, suggested the authors. The ORBITA (Objective Randomised Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina) trial included 200 patients with severe 70% single vessel stenoses. All patients received 6 weeks of medication optimization, followed by assessments, including cardiopulmonary exercise testing and symptom questionnaires. Patients were randomly assigned to undergo PCI or a placebo procedure in which patients were briefly sedated and their coronary catheters inserted and withdrawn with no other intervention. There was no significant difference in exercise capacity or symptom improvement between the PCI and placebo groups 6 weeks after PCI or the sham procedure. This despite objective improvements in measures of coronary stenosis in the PCI group. Nevertheless, some patients with stable angina may still opt for PCI to avoid taking antianginal medications for life, noted the authors.
JAMA