{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,30]],"date-time":"2026-10-30T17:23:13Z","timestamp":1793380993774,"version":"4.5.0"},"reference-count":38,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,8,21]],"date-time":"2024-08-21T00:00:00Z","timestamp":1724198400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Eur J Clin Investigation"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec><jats:title>Introduction<\/jats:title><jats:p>Coronary artery disease (CAD) is a main cause of morbidity and mortality. The effectiveness of coronary revascularization in chronic coronary syndromes (CCS) is still debated. Our recent study showed the superiority of coronary revascularization over optimal medical therapy (OMT) in reducing cardiovascular (CV) mortality and myocardial infarction (MI). The recent publication of the ORBITA\u20102 trial suggested superiority of percutaneous coronary revascularization (PCI) in reducing angina and improving quality of life. Therefore, we aimed to provide an updated meta\u2010analysis evaluating the impact of PCI on both clinical outcomes and angina in CCS.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Relevant studies were screened in PubMed\/Medline until 08\/01\/2024. Randomized controlled trials (RCTs) comparing PCI to OMT in CCS were selected. The primary outcome was CV death. Secondary outcomes were MI, all\u2010cause mortality, stroke, major bleeding and angina severity.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Nineteen RCTs involving 8616 patients were included. Median follow\u2010up duration was 3.3\u2009years. Revascularization significantly reduced CV death (4.2% vs. 5.5%; OR\u2009=\u2009.77; 95% CI .62\u2013.96, <jats:italic>p<\/jats:italic>\u2009=\u2009.02). Subgroup analyses favoured revascularization in patients without chronic total occlusions (CTOs) (<jats:italic>p<\/jats:italic>\u2009=\u2009.052) and those aged &lt;65\u2009years (<jats:italic>p<\/jats:italic>\u2009=\u2009.02). Finally, a follow\u2010up duration beyond 3\u2009years showed increased benefit of coronary revascularization (<jats:italic>p<\/jats:italic>\u2009=\u2009.04). Secondary outcomes analyses showed no significant differences, except for a lower angina severity in the revascularization group according to the Seattle Angina Questionnaire (SAQ) (<jats:italic>p<\/jats:italic>\u2009=\u2009.04) and to the Canadian Cardiovascular Society (CCS) classification (<jats:italic>p<\/jats:italic>\u2009=\u2009.005).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>PCI compared to OMT significantly reduces CV mortality and angina severity, improving quality of life in CCS patients. This benefit was larger without CTOs, in patients aged &lt;65\u2009years and with follow\u2010up duration beyond 3\u2009years.<\/jats:p><\/jats:sec>","DOI":"10.1111\/eci.14303","type":"journal-article","created":{"date-parts":[[2024,8,22]],"date-time":"2024-08-22T00:40:27Z","timestamp":1724287227000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["Percutaneous coronary revascularization versus medical therapy in chronic coronary syndromes: An updated meta\u2010analysis of randomized controlled trials"],"prefix":"10.1111","volume":"54","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6596-0921","authenticated-orcid":false,"given":"Giuseppe","family":"Panuccio","sequence":"first","affiliation":[{"name":"Department of Experimental and Clinical Medicine Magna Graecia University  Catanzaro Italy"},{"name":"Department of Cardiology, Angiology and Intensive Care Medicine Deutsches Herzzentrum der Charit\u00e9, Berlin  Berlin Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicole","family":"Carabetta","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences Magna Graecia University  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Torella","sequence":"additional","affiliation":[{"name":"Department of Experimental and Clinical Medicine Magna Graecia University  Catanzaro Italy"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Salvatore","family":"De\u00a0Rosa","sequence":"additional","affiliation":[{"name":"Department of Medical and Surgical Sciences Magna Graecia University  Catanzaro 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