Current Indications for Percutaneous Coronary Intervention for Chronic Stable Angina: Implications of the COURAGE Trial

Abstract

Patients presenting with symptoms of chronic stable angina represent a relatively significant portion of general population, especially among older aged. Among people 45-54 years old, stable angina is reported between 2-5% in men and 0.5-1% in women,while among people 65-74 years old the corresponding incidence is reported 11-20% for men and 10-14% for women respectively. In >50% of these patients angina limits significantly everyday activities leading to premature retirement, according to various national health and insurance surveys. Chronic stable angina is a slowly progressive disease and the patients show a relative mortality of approximately 2% per year, significantly lower than the mortality of patients with unstable acute coronary syndromes or vascular disease and only slightly higher than that of patients with several risk factors who are under treatment for primary prevention. Mortality among patients with stable angina is related to the extension and the severity of coronary artery disease (CAD), their left ventricular function, exercise capacity, nature of the symptoms and ECG findings both at rest and during stress.