Journal
JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 76, Issue 4, Pages 435-450Publisher
ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2020.05.060
Keywords
coronary artery disease; methods; percutaneous coronary intervention; randomized controlled trials
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The role of percutaneous coronary interventions in addition to medical therapy for patients with stable coronary artery disease continues to be debated in routine clinical practice, despite more than 2 decades of randomized controlled trials. The residual uncertainty arises from particular challenges facing revascularization trials. Which endpoint do doctors care about, and which do patients care about? Which participants should be enrolled? What background medical therapy should we use? When is placebo control relevant? In this paper, we discuss how these questions can be approached and examine the merits and disadvantages of possible options. Engaging multiple stakeholders, including patients, researchers, regulators, and funders, to ensure the design elements are methodologically valid and clinically meaningful should be an aspirational goal in the development of future trials. (c) 2020 the American College of Cardiology Foundation. Published by Elsevier. All rights reserved.
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