Coronary Microvascular Resistance as a Predictor of the Placebo-Controlled Response to Percutaneous Coronary Intervention: Microvascular-Stratified Analysis of ORBITA
Primary result · Placebo-controlled change in treadmill exercise time, by MVRCFDResult — go to the resultDifference 48 seconds 95% CrI 6–92Authors' conclusion
The placebo-controlled benefit of PCI was greater in patients with lower MVRCFD, but interactions with symptom-based endpoints were modest.
Study context
- Population
- Patients recruited for ORBITA (stable angina, severe single-vessel disease, optimal medical therapy)
- Participants
- 131 patients
- Comparison
- Percutaneous coronary intervention (PCI) vs placebo, by microvascular resistance
- PCIn = 66
- Placebon = 65reference
- Primary endpoint
- Placebo-controlled change in treadmill exercise time by hyperemic MVRCFD
- Follow-up
- 6-week follow-up
Methodological detailsplacebo-controlled, computational fluid dynamics
- Placebo-controlled
- Computational fluid dynamics
Primary result
As reported in the abstract
Placebo-controlled change in treadmill exercise time, by MVRCFD
Difference
48 seconds
95% CrI 6–92
PCIvs Placebo
difference 48 seconds (95% CrI 6–92)
- Exercise time did not improve with high (80th centile) MVRCFD
- 16 seconds; 95% CrI: −29 to 61 seconds; Pr = 75.2%
Further findings
MVRCFD distribution
- Median MVRCFD 1.38 mm Hg · min/mL
- Q1-Q3: 0.89-2.09 mm Hg · min/mL
Baseline exercise time vs MVRCFD
- Ordinal correlation coefficient
- 0.20 (95% CrI: 0.18-0.22)
Freedom from angina, angina frequency, stress echo scores, low MVRCFD
- Complete freedom from angina, PCI benefit
- Pr = 98.8%
- Angina frequency improvement
- Pr = 97.8%
- Stress echocardiography scores improvement
- Pr = 99.9%
Original publication
Coronary Microvascular Resistance as a Predictor of the Placebo-Controlled Response to Percutaneous Coronary Intervention: Microvascular-Stratified Analysis of ORBITA. JACC Cardiovasc Interv. Published 27 April 2026. doi:10.
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