Document Detail

How and when to decide on revascularization in stable ischemic heart disease.
MedLine Citation:
PMID:  23143818     Owner:  NLM     Status:  PubMed-not-MEDLINE    
Coronary artery disease is the leading cause of death and disability worldwide. While an invasive strategy of early revascularization reduces cardiovascular morbidity and mortality in patients with acute coronary syndromes, there is no convincing evidence that this strategy leads to an incremental survival advantage for patients with stable ischemic heart disease (SIHD) beyond that achieved by optimal medical therapy. Two landmark trials, COURAGE and BARI 2D, suggest that a strategy of aggressive medical therapy is a reasonable initial approach to such patients. However, there remain certain groups of patients, those with at least moderate ischemia on baseline stress testing, where there is still clinical equipoise. Major society guidelines favor revascularization based on observational data and trials of CABG conducted decades ago, yet data from modern randomized trials are lacking. Ongoing trials such as ISCHEMIA should provide clinicians with evidence to guide selection of the appropriate initial management strategy for patients with SIHD.
Alicia Mecklai; Sripal Bangalore; Judith Hochman
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Current treatment options in cardiovascular medicine     Volume:  15     ISSN:  1092-8464     ISO Abbreviation:  Curr Treat Options Cardiovasc Med     Publication Date:  2013 Feb 
Date Detail:
Created Date:  2013-01-28     Completed Date:  2013-01-29     Revised Date:  2013-07-25    
Medline Journal Info:
Nlm Unique ID:  9815942     Medline TA:  Curr Treat Options Cardiovasc Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  79-92     Citation Subset:  -    
Leon Charney Division of Cardiology, New York University School of Medicine, 530 First Avenue, Skirball 9R, New York, NY, 10016, USA.
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