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Revascularisation led to less angina and fewer adverse cardiac events than did optimal medical care in angina pectoris in the elderly

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 QUESTION: In older patients with at least Canadian Cardiac Society (CCS) class II angina pectoris, is an invasive strategy of left heart catheterisation followed by either percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) more effective than a strategy of optimised medical treatment?


Randomised (allocation concealed*), unblinded,* controlled trial with 6 months of follow up.


{14 university and non-university hospitals} in Switzerland.


305 patients who were ≥ 75 years of age (mean age 80 y, 56% men) with at least CCS class II angina pectoris despite treatment with ≥ 2 antianginal drugs. Exclusion criteria included acute myocardial infarction (MI) within the previous 10 days, concomitant valvular or other heart disease, predominant congestive heart failure, and life-limiting comorbid disease. 4 patients (2 …

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  • * See glossary.

  • Information provided by the author.

  • Sources of funding: Swiss Heart Foundation Berne, Switzerland, and ADUMED Foundation, Switzerland.

  • For correspondence: Professor M Pfisterer, University Hospital, Basel, Switzerland. pfisterer{at}