BibTex format
@article{Simader:2026:10.1016/j.jacc.2025.10.086,
author = {Simader, FA and Rajkumar, CA and Foley, MJ and Ahmed-Jushuf, F and Chotai, S and Chiew, K and Naderi, Z and Davies, JR and Keeble, TR and O'Kane, PD and Haworth, P and Nijjer, SS and Howard, JP and Cole, G and Harrell, FE and Francis, DP and Shun-Shin, MJ and Al-Lamee, RK and ORBITA-2, Investigators},
doi = {10.1016/j.jacc.2025.10.086},
journal = {J Am Coll Cardiol},
pages = {253--265},
title = {Association Between Age and PCI Effectiveness in Stable CAD: Secondary Analysis of ORBITA-2.},
url = {http://dx.doi.org/10.1016/j.jacc.2025.10.086},
volume = {87},
year = {2026}
}
RIS format (EndNote, RefMan)
TY - JOUR
AB - BACKGROUND: ORBITA-2 (Objective Randomized Blinded Investigation With Optimal Medical Therapy of Angioplasty in Stable Angina) was the first randomized placebo-controlled trial to show the efficacy of percutaneous coronary intervention (PCI) in patients with stable angina and single- or multivessel coronary artery disease without background antianginal medication. Whether the effect is consistent across age groups is unknown. OBJECTIVES: The authors sought to evaluate the interaction between age and symptom and stenosis severity, and the efficacy of PCI on the ORBITA-2 primary and secondary endpoints. METHODS: All patients from the primary ORBITA-2 trial contributed data to this post hoc analysis. For daily symptoms, a bayesian longitudinal Markov model was constructed. For treadmill exercise time, stress echocardiography, and questionnaires, a bayesian ordinal proportional odds model was used, including the prerandomization value and treatment arm, which were allowed to interact with age. RESULTS: The mean age was 64 ± 9 years, ranging from 40 to 82 years. There was little relationship between age and symptom and stenosis severity. In older patients, PCI was more effective for symptom relief (OR: 2.03; 95% CrI: 1.67-2.45; Pr > 0.99) than in younger patients (OR: 1.70; 95% CrI: 1.38-2.15; Pr > 0.99; Pr [interaction] = 0.99). In contrast, the effect of PCI on treadmill exercise time was far greater in younger than in older patients (50-year-old: +125 s [95% CrI: 35.8-215.0 s; Pr > 0.99]; 70-year-old: +31.9s [95% CrI: -12.6 to 78.3; Pr = 0.92]; Pr [interaction] = 0.96). CONCLUSIONS: PCI was effective across all ages in reducing angina frequency. Notably, there was limited improvement in treadmill exercise time in the elderly, challenging its role as a primary endpoint in many antianginal trials. These data should inform cardiovascular clinical trial design to ensure applicability across all ages. (Objective Randomized Blinded Investigation With Optimal
AU - Simader,FA
AU - Rajkumar,CA
AU - Foley,MJ
AU - Ahmed-Jushuf,F
AU - Chotai,S
AU - Chiew,K
AU - Naderi,Z
AU - Davies,JR
AU - Keeble,TR
AU - O'Kane,PD
AU - Haworth,P
AU - Nijjer,SS
AU - Howard,JP
AU - Cole,G
AU - Harrell,FE
AU - Francis,DP
AU - Shun-Shin,MJ
AU - Al-Lamee,RK
AU - ORBITA-2,Investigators
DO - 10.1016/j.jacc.2025.10.086
EP - 265
PY - 2026///
SP - 253
TI - Association Between Age and PCI Effectiveness in Stable CAD: Secondary Analysis of ORBITA-2.
T2 - J Am Coll Cardiol
UR - http://dx.doi.org/10.1016/j.jacc.2025.10.086
UR - https://www.ncbi.nlm.nih.gov/pubmed/41603507
VL - 87
ER -