In patients with non–flow-limiting vulnerable plaques, percutaneous coronary intervention plus optimal medical therapy reduced the risk for adverse cardiac events and death compared with optimal medical therapy alone.
Patients with non–flow-limiting vulnerable coronary plaques were randomly assigned to either PCI plus optimal medical therapy or optimal medical therapy alone, stratified by diabetes status and the performance of PCI in a nonstudy target vessel. The primary outcome was target vessel failure: A composite of death from cardiac causes, target vessel MI, ischemia-driven target vessel revascularization, or hospitalization for unstable or progressive angina at 2 years.
"Basically, we prevented every type of the component events — all of them were consistently reduced in the right direction," Stone said,"and there were no major safety concerns with this therapy." Stone noted that although the data from this study are"pretty strong," he would like to see a confirmatory study before recommending that clinicians start performing preventive PI for vulnerable lesions."But I think it is a therapy that could be considered in select situations, after an informed discussion with the patient.", Josip A.