Objective Randomised Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina

Defining a Gold Standard for Ischaemia: Effects of Interventional Revascularisation Versus Optimum Medical Therapy on Exercise Capacity in Patients With Stable Coronary Artery Disease

In this study the investigators will use careful scientific blinding of patient and their subsequent healthcare staff so that the investigators can determine exactly how much difference coronary angioplasty makes to symptoms and blood supply to the heart. After the 6 weeks blinded phase, all patients will be unblinded and the patients who had undergone sham procedure will be offered the active therapy.

The investigators will perform a multi-centre prospective randomised double-blinded comparison of the treatment of stable angina with percutaneous coronary intervention (PCI) and optimal medical therapy (OMT) versus a sham procedure and OMT. Two hundred patients with stable angina and one or more angiographically significant coronary stenosis of 70% or more in a single vessel that is suitable for angioplasty will be recruited. Baseline investigation of functional capacity and myocardial ischaemic burden will be performed. This will be followed by a coronary angiogram and invasive physiological investigation followed by randomisation to PCI or a sham procedure. Follow-up investigation of functional capacity and myocardial ischaemic burden at 6 weeks will then be performed.

Inclusion Criteria:

• Stable angina and at least 1 lesion with angiographic stenosis ≥70% in a single vessel suitable for stent implantation

Exclusion Criteria:

• Acute coronary syndrome
• Previous coronary artery bypass graft surgery
• Left main stem disease
• Contraindications to PCI or drug-eluting stent (DES) implantation
• Heavily calcified or tortuous vessels
• Chronic total occlusion in target vessel
• Life expectancy <2yr
• Pregnancy
• Age <18yr or >85yr
• Angiographic stenosis ≥ 50% in non-target vessel
• Inability to consent