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A placebo-controlled trial of PCI for stable angina

One-paragraph summary

ORBITA-2 randomized symptomatic patients with severe coronary stenosis and ischemia, receiving little or no antianginal medication, to PCI or placebo procedure. PCI improved the angina symptom score (2.9 vs 5.6; odds ratio for better outcome 2.21) over 12 weeks (Rajkumar 2023, PMID 38015442).

Key findings

  • PCI has a genuine placebo-controlled symptom effect.
  • Individual response varied widely.
  • The design isolated PCI as an antianginal treatment rather than an add-on to maximized drug therapy.

Limitations

  • Short follow-up and selected expert centers.
  • Not powered for mortality or MI.
  • Medication minimization differs from usual stepped care.

Why it matters

Together with ORBITA, the trial established sham-controlled interventional cardiology as feasible and replaced polarized “PCI works/does not work” claims with a symptom-specific effect.

Cited by wiki pages

  • Stable CAD management
  • Clinical trials landscape
  • Patient experience