Trial reportThe New England journal of medicine2015
Effect of PCI on Long-Term Survival in Patients with Stable Ischemic Heart Disease.
Trial report in The New England journal of medicine, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00007657 (CSP #424 - Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation), which is not on this map. Cited by 93 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
CSP #424 - Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation
Who cites it
93 citing papers in PubMed, 1 synthesis or guideline pooled it, 288 citations in OpenAlex.
- Screening for coronary artery disease in patients with type 2 diabetes: a meta-analysis and trial sequential analysis.BMJ open · 2017Pooled it
- Effects of ginseng berry saponins on cardiorespiratory fitness in patients with SCAD: a randomized, double-blinded, placebo-controlled trial.Frontiers in pharmacology · 2026Trial
- Use of coronary artery bypass graft surgery and percutaneous coronary intervention and associated outcomes in the ISCHEMIA trial.American heart journal · 2025Trial
- Clinical risk prediction, coronary computed tomography angiography, and cardiovascular events in new-onset chest pain: the PROMISE and SCOT-HEART trials.European heart journal · 2025Trial
- Trial
- Comparison of Characteristics and Outcomes of Veterans With Stable Ischemic Heart Disease Enrolled in the COURAGE Trial Versus the Veterans Affairs Clinical Assessment, Reporting, and Tracking Program.The American journal of cardiology · 2022Trial
- Influence of Cardiac CT based disease severity and clinical symptoms on the diagnostic performance of myocardial perfusion.The international journal of cardiovascular imaging · 2019Trial
- Long-Term Survival Following Multivessel Revascularization in Patients With Diabetes: The FREEDOM Follow-On Study.Journal of the American College of Cardiology · 2019Trial
- Trial
- Invasive and medical management approaches to non-acute myocardial ischaemic syndromes.Nature reviews. Cardiology · 2026Review
- Declining use of percutaneous coronary intervention across population groups, 2011-2022.Health affairs scholar · 2026Article
- Natural history and outcomes of medically treated coronary artery disease: insights from reconstructed individual patient data of 29 randomized trials.Clinical research in cardiology : official journal of the German Cardiac Society · 2025Article
- Revascularization in Stable Coronary Disease: A Systematic Review and Meta-Analysis of Randomized Clinical Trials.The International journal of angiology : official publication of the International College of Angiology, Inc · 2025Review
- A machine learning model using echocardiographic myocardial strain to detect myocardial ischemia.Internal and emergency medicine · 2025Article
- Trimetazidine in Cardiovascular Disease and Beyond: A Comprehensive Review.American journal of cardiovascular drugs : drugs, devices, and other interventions · 2025Review
- The role of cardiac imaging in the post-ISCHEMIA world.The British journal of radiology · 2025Review
- Cardiovascular Care in Women Veterans: An Updated Profile.Current cardiology reports · 2025Review
- Implementation of a national AI technology program on cardiovascular outcomes and the health system.Nature medicine · 2025Observational
- AI-based Assessment of Risk Factors for Coronary Heart Disease in Patients With Diabetes Mellitus and Construction of a Prediction Model for a Treatment Regimen.Reviews in cardiovascular medicine · 2025Article
- Comparative outcomes of invasive versus conservative strategy in stable coronary artery disease patients: a risk-stratification-based hypothesis-generative study.BMC medicine · 2025Observational
33 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
14 authors at 11 institutions in 3 countries.
Funding
Abstract
backgroundPercutaneous coronary intervention (PCI) relieves angina in patients with stable ischemic heart disease, but clinical trials have not shown that it improves survival. Between June 1999 and January 2004, we randomly assigned 2287 patients with stable ischemic heart disease to an initial management strategy of optimal medical therapy alone (medical-therapy group) or optimal medical therapy plus PCI (PCI group) and did not find a significant difference in the rate of survival during a median follow-up of 4.6 years. We now report the rate of survival among the patients who were followed for up to 15 years.
methodsWe obtained permission from the patients at the Department of Veterans Affairs (VA) sites and some non-VA sites in the United States to use their Social Security numbers to track their survival after the original trial period ended. We searched the VA national Corporate Data Warehouse and the National Death Index for survival information and the dates of death from any cause. We calculated survival according to the Kaplan-Meier method and used a Cox proportional-hazards model to adjust for significant between-group differences in baseline characteristics.
resultsExtended survival information was available for 1211 patients (53% of the original population). The median duration of follow-up for all patients was 6.2 years (range, 0 to 15); the median duration of follow-up for patients at the sites that permitted survival tracking was 11.9 years (range, 0 to 15). A total of 561 deaths (180 during the follow-up period in the original trial and 381 during the extended follow-up period) occurred: 284 deaths (25%) in the PCI group and 277 (24%) in the medical-therapy group (adjusted hazard ratio, 1.03; 95% confidence interval, 0.83 to 1.21; P=0.76).
conclusionsDuring an extended-follow-up of up to 15 years, we did not find a difference in survival between an initial strategy of PCI plus medical therapy and medical therapy alone in patients with stable ischemic heart disease. (Funded by the VA Cooperative Studies Program and others; COURAGE ClinicalTrials.gov number, NCT00007657.).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.