Initial Invasive or Conservative Strategy for Stable Coronary Disease

In this RCT (n=5179), an initial invasive strategy was not associated with improved outcomes vs. medical therapy alone in patients with stable coronary disease and moderate or severe ischaemia (composite outcome in 5.3% v 3.4%; absolute difference 1.9%; 95% CI 0.8 to 3.0).

SPS commentary:

A secondary objective of this trial was to assess angina-related health status among these patients. A separate report on this notes that increases in the Seattle Angina Questionnaire summary scores were higher in those randomised to an invasive treatment strategy. The mean differences were modest and reflected minimal differences among asymptomatic patients and larger differences among those with angina at baseline.


New England Journal of Medicine

Resource links:

Angina symptoms publication