Background :In patients with stable coronary artery disease, it remains unclear whether an initial management strategy of percutaneous coronary intervention (PCI) with intensive pharmacologic therapy and lifestyle intervention (optimal medical therapy) is superior to optimal medical therapy alone in reducing the risk of cardiovascular events (10). Objectives: This study was conducted to compare the consequences of initial treatment with percutaneous coronary intervention (PCI) and intensive medical therapy versus intensive medical therapy alone in patients with stable coronary artery disease. Methods :Sixty patients wl. ) had objective evidence of myocardial ischemia and significant coronary artery disease were subjected to either PCI and intensive medical therapy or intensive medical therapy alone.30 patients were assigned to undergo PCI with optimal medical therapy (PCI group) and another 30 patients to receive optimal medical therapy alone (medical therapy group).All patients were followed up for 1-.3 years (mea 2 years) for death, myocardial infarction and stroke. Results: In both groups there was 3 deaths, tile PCI group showed 5 myocardial infaretions,2 per procedural and 3 spontaneous vs 4 spontaneous myocardial infarctions in the medical therapy group. The rate of revascularization was significantly higher among the medical therapy group ( 10 patients) compared to 5 patients in the PCI group .Also, in the PCI group 5 patients were hospitalized because of acute coronary syndrome compared to 11 patients in the medical therapy group .One patient of (,1ch group has a stroke. conclusions :As an initial management strateg. in patients with stable coronary artery disease, PCI did not reduce the risk of death, -myocardial infarction, or stroke when added to optimal medical therapy but it reduces the incidence of anginal attacks, hospitalization and the need for hospitalization.