Interpreting the results of the COURAGE trial: a non-interventionalist perspective.
The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial was designed to determine whether percutaneous coronary intervention (PCI) coupled with optimal medical therapy (OMT) reduced the risk of death or nonfatal myocardial infarction in patients with stable coronary artery disease as compared with OMT alone. COURAGE demonstrated that an initial strategy of PCI added to OMT in these patients relieved angina to a greater extent than an initial strategy of OMT alone for a period of approximately 24 months. The initial strategy of PCI (plus OMT) did not reduce death, myocardial infarction, or other major cardiovascular events compared with OMT alone. The important quality-of-life findings permit physicians to engage in an evidence-based discussion with patients about the expected clinical and health status benefits of initial versus deferred PCI when added to OMT.
Boden
William E
WE
Department of Medicine and Preventive Medicine, University at Buffalo School of Medicine, and Buffalo General Hospital, Buffalo, NY, USA.
D000787:Angina Pectoris / Q000209:etiology / Q000517:prevention & control; D015906:Angioplasty, Balloon, Coronary / Q000009:adverse effects / Q000401:mortality; D002317:Cardiovascular Agents / Q000009:adverse effects / Q000627:therapeutic use*; D002986:Clinical Trials as Topic; D003131:Combined Modality Therapy; D003324:Coronary Artery Disease / Q000150:complications / Q000188:drug therapy / Q000401:mortality / Q000628:therapy*; D019317:Evidence-Based Medicine; D006801:Humans; D015337:Multicenter Studies as Topic; D009203:Myocardial Infarction / Q000209:etiology / Q000401:mortality / Q000517:prevention & control*; D018579:Patient Selection; D011788:Quality of Life; D018570:Risk Assessment; D013997:Time Factors; D016896:Treatment Outcome
D002317:Cardiovascular Agents