Document Detail

Point: a prescription to decrease left ventricular function.
MedLine Citation:
PMID:  19751478     Owner:  NLM     Status:  MEDLINE    
The Courage Trial, published in 2007, has significantly reduced the incidence of treating stable angina with angioplasty. The investigators randomized 2297 patients with documented cardiac ischemia to conservative or invasive therapy and concluded that there was no difference in major events during a follow-up of 2.5 to 7 years and that the urge to open the narrowed artery was unjustified. Over the years it has been well documented by myocardial biopsy that repeated ischemic episodes result in replacement of myocardial cells by fibrous tissue, loss of mitochondria, and deterioration of left ventricular function. Ischemic episodes often occur in the absence of angina so that it is impossible to determine whether the therapy is reducing the magnitude or duration of the process. Also, in their study, 32% of the conservatively treated patients crossed over to invasive. The evidence indicated that conservative treatment may result in a progressive decrease in left ventricular function.
Myrvin H Ellestad
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Publication Detail:
Type:  Editorial    
Journal Detail:
Title:  Preventive cardiology     Volume:  12     ISSN:  1751-7141     ISO Abbreviation:  Prev Cardiol     Publication Date:  2009  
Date Detail:
Created Date:  2009-09-15     Completed Date:  2010-03-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9813731     Medline TA:  Prev Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  169-70     Citation Subset:  IM    
Copyright Information:
Copyright 2009 Wiley Periodicals, Inc.
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MeSH Terms
Angina Pectoris / physiopathology,  therapy
Angioplasty, Transluminal, Percutaneous Coronary
Myocardial Ischemia / physiopathology*,  therapy
Ventricular Function, Left*
Comment In:
Prev Cardiol. 2009 Fall;12(4):171-2   [PMID:  19751479 ]

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