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[Correspondence] Percutaneous coronary intervention for stable angina in ORBITA

The ORBITA trial1 by Rasha Al-Lamee and coworkers has several issues that affect its validity. In ORBITA, 57 (29%) of patients had a fractional flow reserve (FFR) more than 0·80 and 64 (32%) had an instantaneous flow ratio more than 0·89, values above the ischaemic thresholds. These patients would not be expected to have symptomatic improvement with antianginal therapy or percutaneous coronary intervention (PCI) and including them could have biased the results.