AHA 2023 | ORBITA-2: PCI vs. Placebo in Stable Angina for Symptom Reduction

In patients with stable chronic angina, percutaneous coronary intervention (PCI) is often conducted to relieve symptoms. However, there is still some uncertainty regarding whether PCI provides superior symptomatic relief compared with a placebo in patients not receiving anti-anginal medication.

AHA 2023 | ORBITA-2: Angioplastia coronaria vs placebo en angina estable para la reducción de síntomas

Researchers conducted a controlled and randomized study in which patients with stable angina discontinued all anti-anginal medication and underwent a two-week evaluation before randomization. The primary endpoint (PEP) was the angina symptom score.

In total, 301 patients enrolled in the study; 151 were randomized to the PCI group and 150 to the placebo group. The average age was 65 years, and most subjects were men. About 80% of the patients experienced ischemia in one territory, followed by 17% in two territories, and 2% in three territories. The mean fractional flow reserve in treated vessels was 0.63 (interquartile range: 0.49-0.75).

Read also: Untreated Aortic Stenosis: Associated Mortality and a Call to Attention.

Regarding the results, the mean angina symptom score was 2.9 in the PCI group and 5.6 in the placebo group (odds ratio: 2.21, 95% confidence interval: 1.41-3.47, P < 0.001).


In patients with stable angina who received little or no anti-anginal medication and showed positive evidence of ischemia in exercise studies, PCI led to a lower angina symptom score compared with placebo, suggesting an improvement in health status with respect to symptoms.

Dr. Andrés Rodríguez.
Member of the Editorial Board of SOLACI.org.

Original Title: A Placebo-Controlled Trial of Percutaneous Coronary Intervention for Stable Angina.

Reference: Christopher A. Rajkumar, M.B et al. 

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