The AHA Guidelines and Scientific Statements Handbook

Chapter 6 Percutaneous Coronary Intervention

performed or given. Within the limitation of
comparison given these differences in wording of
recommendations, there are no major variations in
recommendations for the use of PCI or adjunctive
therapies. The ESC guidelines do not include recom-
mendations for secondary prevention with their PCI
guidelines.

Ongoing research efforts and future
directions

The COURAGE (Clinical Outcomes Utilizing Revas-
cularization and Aggressive Drug Evaluation) Trial
[30] comparing treatment with PCI and optimal
medical therapy to optimal medical therapy alone in
patients with stable angina was published after the
inclusion deadline for the 2007 PCI Focused Update.
Therefore, its fi ndings are not included in the evi-
dence base for these guidelines. Currently, the
guideline for treatment of patients with chronic

stable angina is undergoing an update, and if evi-

dence from the COURAGE trial or similar studies

should result in a change in recommendations, the

PCI guidelines will be updated as well. Several

studies are now under way to investigate the risk and

appropriateness of therapy to prevent late stent

thrombosis. Evidence from these trials may result in

an update of current recommendations. Finally,

studies involving the use of adjunctive therapies for

patients undergoing PCI, especially newer antiplate-

let medications, could result in a change in the

current guideline recommendations.

References available online at http://www.Wiley.com/go/

AHAGuidelineHandbook.

During the production of this book this relevant

AHA statement and guideline was published: Percu-

taneous and Minimally Invasive Valve Procedures,

http://circ.ahajournals.org/cgi/content/full/117/13/

1750.