COURAGE
Clinical Outcomes Utilising Revascularisation and Aggressive Drug Evaluation
Patient / Population Intervention / Exposure Comparison Outcome
In 2,287 patients with stable coronary artery disease, PCI added to optimal medical therapy did not reduce death or non-fatal MI compared with optimal medical therapy alone.
N
2,287
Design
RCT, median 4.6 yr
Endpoint
Death or non-fatal MI
Relevance
3
Result19.0 % vs 18.5 % (HR 1.05, ns). Angina relief favoured PCI early but converged by 5 yr.
Boden WE, et al. N Engl J Med. 2007;356(15):1503-1516. 10.1056/NEJMoa070829
Discussion & critique
Bare-metal stent era, ~ 30 % crossover from medical arm to PCI. Did not include FFR guidance. Still the conceptual anchor for medical-therapy-first.