Is percutaneous coronary intervention combined with medical therapy better than medical therapy alone for reducing cardiovascular mortality in patients with known coronary artery disease?

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Abstract

EVIDENCE-BASED ANSWER

Percutaneous coronary intervention (PCI) combined with medical therapy may improve short-term mortality in patients with known coronary artery disease (CAD) and objective ischemia (SOR: A, meta-analysis of RCTs). However, over the long-term (5 years) in similar patients, PCI combined with medical therapy does not improve morbidity or mortality over medical therapy alone (SOR: A, meta-analysis of RCTs). Coronary artery bypass grafting (CABG) should be offered over PCI to improve survival in patients with diabetes mellitus and multivessel CAD; however, the role of PCI over medical therapy in patients with stable CAD is unclear (SOR: C, consensus opinion).

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