Percutaneous transluminal coronary angioplasty improved long-term angina status more than medical therapy in coronary artery disease.

M e t h o d s Design: Randomized controlled trial (Second Randomized Intervention Treatment of Angina [RITA-2] Trial). Allocation: {Concealed}†.* Blinding: Blinded (outcome assessors).* Follow-up period: Median 7 years. Setting: 20 centers in the United Kingdom and Ireland. Patients: 1018 patients > 18 years of age (median age 58 y, 82% men) with arteriographically proven coronary artery disease who were considered suitable for either PTCA or medical therapy. Exclusion criteria were previous myocardial revascularization, left main stem disease, recent acute coronary syndrome, hemodynamically significant valve disease, life-threatening noncardiac disease, or need for revascularization. Intervention: Patients were allocated to PTCA (n = 504) or conservative medical therapy consisting of appropriate antiangina medication for symptom relief (n = 514). Outcomes: Composite endpoint of death or definite nonfatal myocardial infarction (MI). Secondary outcomes included all-cause mortality, MI, cardiac death, and angina. Patient follow-up: 98% (intention-to-treat analysis).