Coronary disease & ACS

Randomized, Placebo-Controlled Trial of Chronic Total Occlusion Percutaneous Coronary Intervention in Stable Angina: The ORBITA-CTO Trial

J Am Coll CardiolPublished Randomised controlled trial

Primary result · Angina symptom scoreResult — go to the resultOdds ratio 4.38 95% CrI 1.57–12.69

Authors' conclusion

In patients with symptomatic single-vessel CTO, CTO PCI improves angina beyond placebo.

Study context

Population
Patients with angina attributable to a single-vessel CTO, without bystander coronary diseaseall 50 in primary analysis
Participants
50 patients
Comparison
CTO PCI vs placebo procedure
  • CTO PCIn = 25
  • Placebon = 25reference
Primary endpoint
Angina symptom score (ordinal scale combining daily symptom burden by ORBITA app, antianginal use and over-ride events)
Follow-up
6 months
Methodological detailsmulticentre, blinded, placebo-controlled
  • Multicentre
  • Blinded
  • Placebo-controlled

Primary result

Angina symptom score

Odds ratio

4.38

95% CrI 1.57–12.69

CTO PCI vs Placebo
OR 4.38 (95% CrI 1.57–12.69)

As reported in the abstract

Secondary outcomes

OutcomeOR (95% CrI)
Number of angina episodes · CrI; Pr[Benefit] = 0.997 · CrI4.38 (1.55–11.78)

Days free of angina

Additional days free of angina
30.6 (95% CrI 11.1-50.7; Pr[Benefit] >0.999)

Seattle Angina Questionnaire angina frequency

Improvement in SAQ angina frequency
+10.7 (95% CrI 1.4-20.2; Pr[Benefit] = 0.988)
Improvements also in SAQ physical limitation, quality of life, summary score and Canadian Cardiovascular Society class

Blinding fidelity

Blinding of patients, staff and researchers maintained

Safety

Procedural complication leading to withdrawal

Patient randomized to PCI withdrawn during the procedure because of a complication
1

Original publication

Randomized, Placebo-Controlled Trial of Chronic Total Occlusion Percutaneous Coronary Intervention in Stable Angina: The ORBITA-CTO Trial. J Am Coll Cardiol. Published 29 March 2026. doi:10.1016/j.jacc.2026.03.027

Summarised from the published abstract; every number is checked against it

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