The risk of death, myocardial infarction, or other major cardiovascular events in patients with stable coronary artery disease is no lower with percutaneous coronary intervention (PCI) than with the optimal therapy of drug treatment with lifestyle intervention, says a major prospective study that is predicted to change practice.

The trial, published online on 26 March in the New England Journal of Medicine (http://content.nejm.org, doi: 10.1056/NEJMoa070829), randomised more than 2000 patients with objective evidence of myocardial ischaemia and significant coronary artery disease to PCI or optimal medical treatment. The results showed no difference in mortality from any cause or in the risk of non-fatal myocardial infarction at a median follow up of 4.6 years.

The findings will change practice, said David Taggart, professor of cardiovascular surgery at Oxford University. …