Evidence map›Paper›PMID 17387127›Full record

Trial reportThe New England journal of medicine2007

Optimal medical therapy with or without PCI for stable coronary disease.

William E Boden, Robert A O'Rourke, Koon K Teo, Pamela M Hartigan, David J Maron, William J Kostuk, Merril Knudtson, Marcin Dada, Paul Casperson, Crystal L Harris and 14 more

13 registry-linked trialsOpen access · bronzeAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Publisher
In one paragraph

Trial report in The New England journal of medicine, 2007. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to 13 registered trials, which are not on this map. Cited by 1,328 papers, 8 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
1,328citing papers in PubMed, 8 pooled it
193.6field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT01231165 phase2 / phase3completedstarted 2009, after this paper: background citation

Comparative Randomized Single-blind Trial of Amiloride in Coronary Heart Disease

Ran2009Enrolled70Registered outcomes3Posted comparisons0ConditionsCoronary Heart DiseaseArmsamiloride, Nitrates, clopidogrel, aspirin, statins
PMID 16195332PMID 16717147PMID 16568110PMID 15774613PMID 11854116PMID 8594927PMID 17513945PMID 12829553PMID 15491402PMID 17284700PMID 17194875other papers from this trial
Open the trial in the graph
NCT00007657 phase3completednot on this map

CSP #424 - Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation

TypeinterventionalSponsorUS Department of Veterans AffairsRan1998 to 2006Enrolled3,260ConditionsMyocardial IschemiaArmsIntensive medical therapy, Percutaneous Coronary Intervention (PCI) plus intensive medical therapy
NCT00726921 completednot on this mapstarted 2008, after this paper: background citation

Detection of Significant Coronary Artery Disease in Nephropathy Patients Utilizing Coronary CTA and Real Time Perfusion DSE: Comparison With Quantitative Coronary Angiography and Patient Outcome

TypeobservationalSponsorUniversity of NebraskaRan2008 to 2012Enrolled189ConditionsCoronary Artery Disease, Myocardial Infarction, Stroke, Death
NCT00825604 phase2withdrawnnot on this mapstarted 2009, after this paper: background citation

Quality of Life and Achievement of Target of Treatment After Optimized Medical Treatment, Physical Training and Smoking Cessation With or Without Percutaneous Coronary Intervention in Patients With Stable Angina Pectoris.

TypeinterventionalSponsorGöteborg UniversityRan2009 to 2010Enrolled0ConditionsStable Angina PectorisArmsPercutaneous coronary angioplasty (PCI)
NCT01035047 nacompletednot on this mapstarted 2010, after this paper: background citation

Randomized Investigation of Chest Pain Diagnostic Strategies

TypeinterventionalSponsorWake Forest University Health SciencesRan2010 to 2012Enrolled105ConditionsAcute Coronary Syndrome, Chest PainArmsClinical decision unit care, coupled with cardiac MRI
NCT01262625 naterminatednot on this mapstarted 2011, after this paper: background citation

ACRIN-4701 RESCUE: Randomized Evaluation of Patients With Stable Angina Comparing Utilization of Diagnostic Examinations

TypeinterventionalSponsorAmerican College of RadiologyRan2011 to 2015Enrolled1,050ConditionsChest Pain, Stable Angina Pectoris, CCS Class I to III, Angina Equivalent, Coronary Artery DiseaseArmsCCTA, SPECT MPI/ICA
NCT01551927 completednot on this mapstarted 2011, after this paper: background citation

What Are the Expectations for Future Examination and Treatment in Patients Undergoing Evaluation and Treatment of Coronary Heart Disease?

TypeobservationalSponsorGöteborg UniversityRan2011 to 2014Enrolled754ConditionsCoronary Heart Disease
NCT02652208 nacompletednot on this mapstarted 2016, after this paper: background citation

Randomized Trial Comparing Effectiveness of Two Patient Decision Aids for Stable Chest Discomfort

TypeinterventionalSponsorMassachusetts General HospitalRan2016 to 2016Enrolled34ConditionsCoronary Artery Disease, Stable AnginaArmsOnline decision aid, Video decision aid
NCT02931331 unknown statusnot on this mapstarted 2016, after this paper: background citation

The Impact of Coronary Revascularization on Absolute Myocardial Blood Flow as Assessed by Stress Myocardial Positron Tomography

Typeobservational_patient_registrySponsorOchsner Health SystemRan2016 to 2017Enrolled50ConditionsCoronary Stenoses, Myocardial Ischemia, Coronary Artery Stenosis, Coronary Disease
NCT03044964 phase4unknown statusnot on this mapstarted 2017, after this paper: background citation

Effect of Ranolazine on Activity Level in Patients With Angina After FFR Based Deferred Intervention

TypeinterventionalSponsorAmit Malhotra, MDRan2017 to 2017Enrolled40ConditionsAnginaArmsRanolazine, Placebo
NCT03180060 completednot on this mapstarted 2015, after this paper: background citation

Accuracy and Heterogeneity of Stress Imaging for Detecting Coronary Artery Disease: A Systematic Review and Meta-Analysis Using HSROC Methods in 23,051 Patients.

TypeobservationalSponsorAmerican British Cowdray Medical CenterRan2015 to 2016Enrolled23,051ConditionsCoronary Disease, Echocardiography, Fractional Flow Reserve, Myocardial, Hemodynamics
NCT07098195 nanot yet recruitingnot on this mapstarted 2025, after this paper: background citation

An OPen-label, Multicentre, Single Arm, Clinical InvestigatIon to Evaluate PerFormance and Safety of RIsoR Crest EveRolimus Eluting Coronary Stent System

TypeinterventionalSponsorPoly Medicure LimitedRan2025 to 2028Enrolled2,000ConditionsCoronary Artery Disease, Coronary Artery Stenosis, Percutaneous Coronary Intervention, de Novo Lesions in Native Coronary ArteriesArmsCoronary Stent
NCT07577518 nanot yet recruitingnot on this mapstarted 2026, after this paper: background citation

Percutaneous Intervention Versus Optimal Medical Therapy in Chronic Coronary Syndrome (PIVOT) Trial

TypeinterventionalSponsorSeoul National University HospitalRan2026 to 2034Enrolled2,301ConditionsChronic Coronary SyndromeArmspercutaneous coronary intervention, Guideline-directed Optimal Medical treatment, Carvedilol Sustained-Release (SR) (Nested RCT subset), Carvedilol Immediate-Release (IR) (Nested RCT subset)
3 · Its place in the literature

Who cites it

1,328 citing papers in PubMed, 8 syntheses or guidelines pooled it, 4,657 citations in OpenAlex.

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  19. Predictors of symptom improvement in patients with chronic coronary syndrome after percutaneous coronary intervention.Clinical research in cardiology : official journal of the German Cardiac Society · 2024
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1,268 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

24 authors at 1 institution in 1 country.

William E BodenWestern New York Veterans Affairs Healthcare Network and Buffalo General Hospital-SUNY, Buffalo, NY 14203, USA. wboden@kaleidahealth.org
Robert A O'Rourke
Koon K Teo
Pamela M Hartigan
David J Maron
William J Kostuk
Merril Knudtson
Marcin Dada
Paul Casperson
Crystal L Harris
Bernard R Chaitman
Leslee Shaw
Gilbert Gosselin
Shah Nawaz
Lawrence M Title
Gerald Gau
Alvin S Blaustein
David C Booth
Eric R Bates
John A Spertus
Daniel S Berman
G B John Mancini
William S Weintraub
COURAGE Trial Research Group
VA Western New York Healthcare System · US

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn patients with stable coronary artery disease, it remains unclear whether an initial management strategy of percutaneous coronary intervention (PCI) with intensive pharmacologic therapy and lifestyle intervention (optimal medical therapy) is superior to optimal medical therapy alone in reducing the risk of cardiovascular events.

methodsWe conducted a randomized trial involving 2287 patients who had objective evidence of myocardial ischemia and significant coronary artery disease at 50 U.S. and Canadian centers. Between 1999 and 2004, we assigned 1149 patients to undergo PCI with optimal medical therapy (PCI group) and 1138 to receive optimal medical therapy alone (medical-therapy group). The primary outcome was death from any cause and nonfatal myocardial infarction during a follow-up period of 2.5 to 7.0 years (median, 4.6).

resultsThere were 211 primary events in the PCI group and 202 events in the medical-therapy group. The 4.6-year cumulative primary-event rates were 19.0% in the PCI group and 18.5% in the medical-therapy group (hazard ratio for the PCI group, 1.05; 95% confidence interval [CI], 0.87 to 1.27; P=0.62). There were no significant differences between the PCI group and the medical-therapy group in the composite of death, myocardial infarction, and stroke (20.0% vs. 19.5%; hazard ratio, 1.05; 95% CI, 0.87 to 1.27; P=0.62); hospitalization for acute coronary syndrome (12.4% vs. 11.8%; hazard ratio, 1.07; 95% CI, 0.84 to 1.37; P=0.56); or myocardial infarction (13.2% vs. 12.3%; hazard ratio, 1.13; 95% CI, 0.89 to 1.43; P=0.33).

conclusionsAs an initial management strategy in patients with stable coronary artery disease, PCI did not reduce the risk of death, myocardial infarction, or other major cardiovascular events when added to optimal medical therapy. (ClinicalTrials.gov number, NCT00007657 [ClinicalTrials.gov].).

Indexed as

Angioplasty, Balloon, CoronaryAdrenergic beta-AntagonistsAgedAngina PectorisAngiotensin-Converting Enzyme InhibitorsAnticholesteremic AgentsAntihypertensive AgentsCombined Modality TherapyCoronary DiseaseDrug Therapy, CombinationFemaleHumansKaplan-Meier EstimateMaleMiddle AgedMyocardial InfarctionAdrenergic beta-AntagonistsAngiotensin-Converting Enzyme InhibitorsAnticholesteremic AgentsAntihypertensive AgentsPlatelet Aggregation Inhibitors

Identifiers

PMID17387127
OpenAlexW2160414137

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

and 7 more above

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.