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Rev Cardiovasc Med. 2009;10 Suppl 2:S34-44.

Interpreting the results of the COURAGE trial: a non-interventionalist perspective.

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  • 1Department of Medicine and Preventive Medicine, University at Buffalo School of Medicine, and Buffalo General Hospital, Buffalo, NY, USA.


The Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial was designed to determine whether percutaneous coronary intervention (PCI) coupled with optimal medical therapy (OMT) reduced the risk of death or nonfatal myocardial infarction in patients with stable coronary artery disease as compared with OMT alone. COURAGE demonstrated that an initial strategy of PCI added to OMT in these patients relieved angina to a greater extent than an initial strategy of OMT alone for a period of approximately 24 months. The initial strategy of PCI (plus OMT) did not reduce death, myocardial infarction, or other major cardiovascular events compared with OMT alone. The important quality-of-life findings permit physicians to engage in an evidence-based discussion with patients about the expected clinical and health status benefits of initial versus deferred PCI when added to OMT.

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