IMR Press / RCM / Volume 10 / Issue S2 / DOI: 10.3909/ricm10S20005

Reviews in Cardiovascular Medicine (RCM) is published by IMR Press from Volume 19 Issue 1 (2018). Previous articles were published by another publisher in Open Access under a CC-BY (or CC-BY-NC-ND) licence, and they are hosted by IMR Press on imrpress.com as a courtesy and upon agreement with MedReviews, LLC.

Open Access Review
Interpreting the Results of the COURAGE Trial: A Non-Interventionalist Perspective
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1 Department of Medicine and Preventive Medicine, University at Buffalo Schools of Medicine and Public Health, Buffalo, NY; Cardiovascular Services, Kaleida Health, Buffalo, NY; Buffalo General and Millard Fillmore Hospitals, Buffalo, NY
Rev. Cardiovasc. Med. 2009, 10(S2), 34–44; https://doi.org/10.3909/ricm10S20005
Published: 20 February 2009
Abstract
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.
Keywords
Coronary artery disease
Percutaneous coronary intervention
COURAGE trial
Angina
Drug-eluting stents
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