Does percutaneous coronary intervention improve long-term survival?

This paper studied the effect of percutaneous coronary intervention (PCI) on survival in patients with ischemic heart disease. The authors concluded that there was no long-term difference in survival in patients who had initial PCI plus medical therapy and patients who had medical therapy only. 

In patients with ischemic heart disease, there is not enough blood flowing to the heart. This is often due to a build-up of fatty substances in the blood vessel, blocking blood flow. PCI is a procedure done to improve blood flow to the heart. PCI involes placing a small tube (a stent) into the blood vessel to open the blockage. Studies have shown that PCI relieves chest pain and reduces the extent of heart attacks. However, it is not clear whether it improves survival. 

The current study examined the effect of PCI on patient survival over 15 years.

1211 patients were included in the study. 613 received PCI plus optimal medical therapy while 598 received only medical therapy. Patients were followed for an average 11.9 years.

41% of patients who received PCI and 42% of patients who received medical therapy alone died. PCI did not significantly change the mortality risk.

The authors concluded that there was no difference in rates of long-term survival with an initial treatment of optimal medical therapy plus PCI as compared with optimal medical therapy alone.

The authors did not have information on whether patients received further procedures during the follow-up period.