Patients with a chronic total blockage of a coronary artery who received angioplasty showed significant reductions in chest pain and improvements in quality of life compared to those who received a placebo procedure, according to research presented at the American College of Cardiology's Annual Scientific Session on Mar. 29.
The findings are notable because this is believed to be the first randomized, placebo-controlled trial examining angioplasty for chronic total occlusion (CTO), a condition that can severely impact quality of life. The study aimed to determine whether reopening blocked arteries would provide measurable benefits beyond any potential placebo effect.
"Our results demonstrate in a randomized, double-blinded study design that coronary angioplasty and stenting is an effective treatment for patients who have a chronic total occlusion and chronic anginal chest pain," said principal investigator John Davies, MRCP, PhD, consultant interventional cardiologist at the Essex Cardiothoracic Center and honorary lecturer at Anglia Ruskin University School of Medicine in the United Kingdom.
The ORBITA-CTO trial enrolled 50 patients with CTO present for at least three months and ongoing angina despite medication. Participants were randomly assigned either angioplasty or a placebo procedure; both groups were blinded to their assignment. Results showed that while some improvement occurred even with placebo, those receiving angioplasty were four times as likely to have improved angina scores. On average over nearly six months, these patients had 31 more angina-free days than those given the placebo procedure. Quality-of-life scores also improved significantly among intervention group participants.
No deaths or heart attacks occurred during the study period. However, researchers cautioned about limitations such as small sample size and exclusion of patients with highly complex CTO features. Davies said further research is needed to identify which patient groups may benefit most from this intervention.
"These results provide hope for both patients with CTO and their doctors that angioplasty with stenting can be successful and can result in reduced angina pain and better quality of life," Davies said.
