6/28/23, 12:17 AM COURAGE Pathway Feedback Search Clinical Topics Home Studies COURAGE COURAGE Disease Coronary artery disease Trial question What is the role of PCI as an initial management strategy in patients with stable coronary artery disease? Study design Multi-center Open label RCT Population Characteristics of study participants 15.0% female N = 2287 85.0% male 2287 patients (338 female, 1947 male) Inclusion criteria: patients who had objective evidence of myocardial ischemia and significant coronary artery disease Key exclusion criteria: severe angina, a markedly positive stress test, refractory HF, cardiogenic shock, ejection fraction < 30%, or revascularization within 6 months Interventions N=1149 PCI (plus optimal medical therapy) N=1138 medical therapy (optimal medical therapy alone) Primary outcome Rate of death or nonfatal myocardial infarction at 4.6 years follow-up 19.0 % 19 18.5 14 3 % https://web.pathway.md/studies/recSHasUo6lbAuG04 1/2 6/28/23, 12:17 AM 14.3 % COURAGE Pathway 9.5 % 4.8 % No significant difference 0.0 % Percutaneous coronary intervention Medical therapy No significant difference in the rate of death or nonfatal myocardial infarction at 4.6 years follow- up (19% vs. 18.5%; HR 1.05, 95% CI 0.87 to 1.27) Secondary outcomes No significant difference in death, myocardial infarction and stroke (20% vs. 19.5%; HR 1.05, 95% CI 0.87 to 1.27) No significant difference in hospitalization for acute coronary syndrome (12.4% vs. 11.8%; HR 1.07, 95% CI 0.84 to 1.37) No significant difference in myocardial infarction (13.2% vs. 12.3%; HR 1.13, 95% CI 0.89 to 1.43) Conclusion In patients who had objective evidence of myocardial ischemia and significant coronary artery disease, PCI was not superior to medical therapy with respect to the rate of death or nonfatal myocardial infarction at 4.6 years follow-up. Reference Boden WE, O'Rourke RA, Teo KK et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007 Apr 12;356(15):1503-16. Open reference URL https://web.pathway.md/studies/recSHasUo6lbAuG04 2/2