Percutaneous coronary intervention (PCI), or angioplasty, is a procedure for expanding narrowed arteries in the heart due to coronary heart disease. It is not clear whether PCI increases quality of life over therapy with medications. According to an article published in the August 14, 2008 issue of the New England Journal of Medicine, percutaneous coronary intervention, or angioplasty, can often be put off in patients with stable coronary artery disease until treatment with medications is given a chance to work.

Research from the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE) trial showed that, among 2287 patients with stable coronary artery disease, optimal medical therapy (OMT), or the best combination of medicines, either with or without PCI, improves quality of life. Gains in physical function and quality of life were significantly greater in patients who underwent PCI in the first one to two years after the procedure. However, by three years of follow-up, there was no significant difference in quality of life compared to patients who were treated with medicines alone.

Because PCI is an invasive procedure, it involves more risk and higher cost than OMT. The results of this study suggest that many patients will get better without having to undergo PCI, unless they have significant symptoms. In the case of stable coronary artery disease, it might be a good strategy to start with an effective combination of medications before considering angioplasty.