Outcome Evaluation of Percutaneous Coronary Intervention vs Medical Therapy Alone in Patients with Chronic Coronary Syndrome

Authors

• Hsien-Yuan Chang, Institute of Clinical Medicine, College of Medicine, National Cheng Kung University, Tainan, Taiwan
• Hsin-Yu Fang, Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
• Mu-Shiang Huang, Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
• You-Zhen Chen, Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
• Di-Yung Chen, Division of Cardiovascular Surgery, Department of Surgery, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
• Edward Chia-Cheng Lai, School of Pharmacy, Institute of Clinical Pharmacy and Pharmaceutical Sciences, College of Medicine, National Cheng Kung University, Tainan, Taiwan
• Jung-Der Wang, Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.
• Yi-Heng Li, Division of Cardiology, Department of Internal Medicine, National Cheng Kung University Hospital, College of Medicine, National Cheng Kung University, Tainan, Taiwan
• Li-Jung Elizabeth Ku, Department of Public Health, College of Medicine, National Cheng Kung University, Tainan, Taiwan.Follow

Keywords

coronary artery disease, drug therapy, percutaneous coronary intervention

Abstract

This study provides real-world evidence by comparing the long-term clinical outcomes of percutaneous coronary intervention (PCI) versus medical therapy alone in patients with chronic coronary syndrome (CCS) diagnosed non-invasively, given the lack of evidence in this population. This retrospective cohort study (2013-2018) utilized data from a medical center’s Cardiovascular Disease Databank, which was linked to national mortality records in Taiwan. Propensity score matching (PSM) and stabilized inverse probability of treatment weighting (IPTW) were applied to adjust for baseline differences between the PCI and medication-only groups. Major adverse cardiovascular events (MACE), including all-cause mortality, non-fatal myocardial infarction (MI), and revascularization, were compared between groups. After 1:4 propensity score matching, a total of 4,369 patients were included (PCI, N=1,058; medication only, N=3,311). Adjusted Cox proportional hazards models showed that the PCI group had a higher hazard of MACE (aHR, 1.38 [95% CI, 1.22-1.56]), primarily driven by increased revascularization (aHR, 1.65 [95% CI, 1.39-1.95]), compared to the medication-only groups. No significant differences were observed in all-cause mortality (aHR, 1.13 [95% CI, 0.96-1.34]) or MI (aHR, 1.08 [95% CI, 0.77-1.52]). Furthermore, the mean total healthcare cost during the index year was US$3,232 (SD = 9,896) for the medication-only group, compared with US$10,931 (SD = 8,781) for the PCI group. Among CCS patients diagnosed non-invasively, the medication-only group demonstrated comparable all-cause mortality and MI rates, but a significantly lower risk of revascularization compared with the PCI group, while incurring only one-third of the healthcare costs. Clinicians should carefully evaluate the benefits and risks of stent placement in CCS patients.

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Recommended Citation

Chang, Hsien-Yuan; Fang, Hsin-Yu; Huang, Mu-Shiang; Chen, You-Zhen; Chen, Di-Yung; Lai, Edward Chia-Cheng; Wang, Jung-Der; Li, Yi-Heng; and Ku, Li-Jung Elizabeth (2026) "Outcome Evaluation of Percutaneous Coronary Intervention vs Medical Therapy Alone in Patients with Chronic Coronary Syndrome," Journal of Food and Drug Analysis: Vol. 34 : Iss. 3 , Article 13.
Available at: https://doi.org/10.38212/2224-6614.3604

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