Which treatment is best for patients with stable ischemic heart disease?

This study compared the treatment of stable ischemic heart disease (SIHD) with percutaneous coronary angioplasty (PCI) or with medication alone. It found that the risk of mortality was the same in both groups.

Coronary artery disease (CAD) is when the blood vessels in the heart become blocked and the heart muscle does not get enough oxygen. CAD can be divided into two types, stable and acute. Stable ischemic heart disease (SIHD) describes CAD which has manageable symptoms and no signs of heart attack or heart failure. Acute disease describes rapidly worsening symptoms or a heart attack. 

Acute disease is usually treated with a procedure to unblock the blood vessels, called percutaneous coronary intervention (PCI). It is unclear whether SIHD should be treated with the PCI procedure or just with medication.

This study compared the results of seven studies involving a total of 12,013 patients. 6,109 were treated with PCI and 5,904 were treated with medication alone. Patients were followed up for up to ten years.

The risk of heart attack was 14% lower in the PCI group. The risk of heart-related death was 18% lower in the PCI group. However, the risk of death from any cause was the same in both groups.

This study showed that SIHD can be treated with either PCI or medication alone. The choice of treatment did not have any impact on the risk of death from any cause.

This study excluded patients with heart failure or with disease in the main arteries of the heart. More studies are needed to see if these results apply to patients with these conditions as well.