Is elective percutaneous coronary intervention a thing of the past?


Take Home Messages
  • Elective PCI has traditionally made up a significant proportion of coronary intervention in the United Kingdom.
  • COURAGE, ISCHAEMIA and ORBITA are key trials which question the evidence behind elective PCI, demonstrating no improvement in MACE.
  • Medical therapy and lifestyle intervention should be first line with judicious use of PCI following informed discussion with patients.

The landscape of interventional cardiology has seen seismic shifts over recent years, with traditional treatments such as elective percutaneous coronary intervention (PCI) facing increasing scrutiny. Evolving evidence and an improved understanding of stable coronary artery disease has led to questions around the supposed benefits of this intervention in patients with stable angina 1,2. This editorial aims to briefly examine the underlying evidence and look to answer the question – is elective PCI a thing of the past?