CBS - The 17th Left Main & Coronary Bifurcation Summit, CBS2025

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Left Main & Coronary Bifurcation Summit (CBS) was founded in 2006 as a think tank dedicated to the treatment of left main and coronary bifurcation lesions. CBS aims to improve cardiological care by refreshing fundamental researches, clinical trials, yearly published guidelines, emerged ideas and case-based discussion.

Association and Affiliations
- Organized by
  
  Nanjing Heart Center
  
  Asian Bifurcation Club (ABC)
  
  Nanjing First Hospital, Nanjing Medical University
- Co-organized by
  
  Chinese Society of Cardiology (CSC)
  
  Capacity Building and Continuing Education Center,National Health and Family Planning Commission (CBCEC)
  
  American Society for Cardiovascular Angiography and Interventions (SCAI)
  
  Asian Heart Society (AHS)
Contact Us
- Registration Administration of Domestic Representatives
  
  Hongjuan Peng : +86-13913895477
  
  Haimei Xu +86-13914736846
  
  cbsnj@cbsmd.cn
- Registration Administration of Overseas Representatives
  
  Ling Lin : +86 (25) 52271398
  
  +86-13951884596
  
  cbs@cbsmd.cn
- Management of Challenging Cases
  
  Yingying Zhao :+86-13815408517
  
  sub@cbsmd.cn
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CBS2019 Congress Secretariat, Nanjing First Hospital, Building No.9 68# Changle Road, Nanjing, China

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Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial Genetics and Causality of Triglyceride-Rich Lipoproteins in Atherosclerotic Cardiovascular Disease Effects of clopidogrel vs. prasugrel vs. ticagrelor on endothelial function, inflammatory parameters, and platelet function in patients with acute coronary syndrome undergoing coronary artery stenting: a randomized, blinded, parallel study Coronary Protection to Prevent Coronary Obstruction During TAVR: A Multicenter International Registry Improved outcomes in patients with ST-elevation myocardial infarction during the last 20 years are related to implementation of evidence-based treatments: experiences from the SWEDEHEART registry 1995-2014 Dynamic Myocardial Ultrasound Localization Angiography Developing a Mobile Application for Global Cardiovascular Education 2016 ACC/AHA/HFSA Focused Update on New Pharmacological Therapy for Heart Failure: An Update of the 2013 ACCF/AHA Guideline for the Management of Heart Failure: A Report of the American College of Cardiology/American Heart Association Task Force on Clinical Practice Guidelines and the Heart Failure

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Clinical Trial2018 Jan 6;391(10115):31-40.

JOURNAL：Lancet. Article Link

Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial

Davies JE, ORBITA investigators et al. Keywords: PCI; stable angina; blinded RCT; exercise timei increment

ABSTRACT

BACKGROUND - Symptomatic relief is the primary goal of percutaneous coronary intervention (PCI) in stable angina and is commonly observed clinically. However, there is no evidence from blinded, placebo-controlled randomised trials to show its efficacy.

METHODS - ORBITA is a blinded, multicentre randomised trial of PCI versus a placebo procedure for angina relief that was done at five study sites in the UK. We enrolled patients with severe (≥70%) single-vessel stenoses. After enrolment, patients received 6 weeks of medication optimisation. Patients then had pre-randomisation assessments with cardiopulmonary exercise testing, symptom questionnaires, and dobutamine stress echocardiography. Patients were randomised 1:1 to undergo PCI or a placebo procedure by use of an automated online randomisation tool. After 6 weeks of follow-up, the assessments done before randomisation were repeated at the final assessment. The primary endpoint was difference in exercise time increment between groups. All analyses were based on the intention-to-treat principle and the study population contained all participants who underwent randomisation. This study is registered with ClinicalTrials.gov, number NCT02062593.

FINDINGS - ORBITA enrolled 230 patients with ischaemic symptoms. After the medication optimisation phase and between Jan 6, 2014, and Aug 11, 2017, 200 patients underwent randomisation, with 105 patients assigned PCI and 95 assigned the placebo procedure. Lesions had mean area stenosis of 84·4% (SD 10·2), fractional flow reserve of 0·69 (0·16), and instantaneous wave-free ratio of 0·76 (0·22). There was no significant difference in the primary endpoint of exercise time increment between groups (PCI minus placebo 16.6 s, 95% CI -8.9 to 42.0, p=0.200). There were no deaths. Serious adverse events included four pressure-wire related complications in the placebo group, which required PCI, and five major bleeding events, including two in the PCI group and three in the placebo group.

INTERPRETATION - In patients with medically treated angina and severe coronary stenosis, PCI did not increase exercise time by more than the effect of a placebo procedure. The efficacy of invasive procedures can be assessed with a placebo control, as is standard for pharmacotherapy.

FUNDING - NIHR Imperial Biomedical Research Centre, Foundation for Circulatory Health, Imperial College Healthcare Charity, Philips Volcano, NIHR Barts Biomedical Research Centre.

Abstract

Recommended Article

Percutaneous coronary intervention in stable angina (ORBITA): a double-blind, randomised controlled trial

ABSTRACT