Randomised controlled trial
Preventive percutaneous coronary intervention versus optimal medical therapy alone for the treatment of vulnerable atherosclerotic coronary plaques (PREVENT): a multicentre, open-label, randomised controlled trial
- Randomised controlled trial
- multicentre
- open-label
- 15 hospitals in 4 countries
Authors' conclusion
In patients with non-flow-limiting vulnerable coronary plaques, preventive percutaneous coronary intervention reduced major adverse cardiac events arising from high-risk vulnerable plaques, compared with optimal medical therapy alone.
Study context
- Population
- Adults with non-flow-limiting (FFR >0.80) vulnerable coronary plaques identified by intracoronary imaging1,556 (97%) completed 2-year follow-up
- Participants
- 1,606 adults
- Comparison
- Percutaneous coronary intervention vs Optimal medical therapy alone
- Percutaneous coronary interventionn = 803
- Optimal medical therapy alonen = 803reference
- Primary endpoint
- Composite of:
- Cardiac death
- Target-vessel MI
- Ischaemia-driven target-vessel revascularisation
- Hospitalisation for unstable or progressive angina (ITT)
- Follow-up
- 2 years
Primary result
As reported in the abstract
Absolute difference
−3.0 percentage points
95% CI −4.4 to −1.8
P = 0.0003
Events by treatment group
PCI vs Optimal medical therapy
absolute difference −3.0 percentage points (95% CI −4.4 to −1.8); P = 0.0003
Further findings
| Outcome | Percutaneous coronary intervention | Optimal medical therapy alone | absolute difference (percentage points) (95% CI) | |
|---|---|---|---|---|
| Death · 2 years · Serious clinical or adverse events did not differ | Not reported in the abstract | 1.3% | −0.8 (−1.7 to 0.2) | |
| −2−101Difference, percentage points (linear scale) |
- Death: PCI 0.5%
Safety
| Outcome | Percutaneous coronary intervention | Optimal medical therapy alone | absolute difference (percentage points) (CI) | |
|---|---|---|---|---|
| MI · 2 years | Not reported in the abstract | 1.7% | −0.5 (−1.7 to 0.6) | |
| −2−101Difference, percentage points (linear scale) |
- MI: PCI 1.1%
Original publication
Preventive percutaneous coronary intervention versus optimal medical therapy alone for the treatment of vulnerable atherosclerotic coronary plaques (PREVENT): a multicentre, open-label, randomised controlled trial. Lancet. Published 8 April 2024. doi:10.1016/s0140-6736(24)00413-6
Summarised from the published abstract; every number is checked against it