Francisco Ujueta1, Ephraim N Weiss1, Binita Shah1, Steven P Sedlis2. 1. Department of Medicine Division of Cardiology New York VA Healthcare Network and New York University School of Medicine, 423 East 23rd Street, New York, NY, 10010, USA. 2. Department of Medicine Division of Cardiology New York VA Healthcare Network and New York University School of Medicine, 423 East 23rd Street, New York, NY, 10010, USA. Steven.Sedlis@va.gov.
Abstract
PURPOSE OF REVIEW: This study aims to determine if percutaneous coronary intervention (PCI) does improve survival in stable ischemic heart disease (SIHD). RECENT FINDINGS: The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial will evaluate patients with moderate to severe ischemia and will be the largest randomized trial of an initial management strategy of coronary revascularization (percutaneous or surgical) versus optimal medical therapy alone for SIHD. Although the ISCHEMIA trial may show a benefit with upfront coronary revascularization in this high-risk population, cardiac events after PCI are largely caused by plaque rupture in segments outside of the original stented segment. Furthermore, given the robust data from prior randomized trials, which showed no survival benefit with PCI, and the likelihood that the highest risk patients in ISCHEMIA will be treated with surgery, it is unlikely that the ISCHEMIA trial will show a survival benefit particular to PCI. RECENT FINDINGS: Although PCI relieves symptoms, the evidence base indicates that it does not prolong survival in SIHD.
PURPOSE OF REVIEW: This study aims to determine if percutaneous coronary intervention (PCI) does improve survival in stable ischemic heart disease (SIHD). RECENT FINDINGS: The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial will evaluate patients with moderate to severe ischemia and will be the largest randomized trial of an initial management strategy of coronary revascularization (percutaneous or surgical) versus optimal medical therapy alone for SIHD. Although the ISCHEMIA trial may show a benefit with upfront coronary revascularization in this high-risk population, cardiac events after PCI are largely caused by plaque rupture in segments outside of the original stented segment. Furthermore, given the robust data from prior randomized trials, which showed no survival benefit with PCI, and the likelihood that the highest risk patients in ISCHEMIA will be treated with surgery, it is unlikely that the ISCHEMIA trial will show a survival benefit particular to PCI. RECENT FINDINGS: Although PCI relieves symptoms, the evidence base indicates that it does not prolong survival in SIHD.
Authors: Friedrich W Mohr; Marie-Claude Morice; A Pieter Kappetein; Ted E Feldman; Elisabeth Ståhle; Antonio Colombo; Michael J Mack; David R Holmes; Marie-angèle Morel; Nic Van Dyck; Vicki M Houle; Keith D Dawkins; Patrick W Serruys Journal: Lancet Date: 2013-02-23 Impact factor: 79.321
Authors: Hemal Gada; Ajay J Kirtane; Dean J Kereiakes; Sripal Bangalore; Jeffrey W Moses; Philippe Généreux; Roxana Mehran; George D Dangas; Martin B Leon; Gregg W Stone Journal: Am J Cardiol Date: 2015-02-12 Impact factor: 2.778
Authors: Sripal Bangalore; Sunil Kumar; Mario Fusaro; Nicholas Amoroso; Michael J Attubato; Frederick Feit; Deepak L Bhatt; James Slater Journal: Circulation Date: 2012-05-14 Impact factor: 29.690
Authors: Eric J Velazquez; Kerry L Lee; Robert H Jones; Hussein R Al-Khalidi; James A Hill; Julio A Panza; Robert E Michler; Robert O Bonow; Torsten Doenst; Mark C Petrie; Jae K Oh; Lilin She; Vanessa L Moore; Patrice Desvigne-Nickens; George Sopko; Jean L Rouleau Journal: N Engl J Med Date: 2016-04-03 Impact factor: 91.245
Authors: Leslee J Shaw; Daniel S Berman; David J Maron; G B John Mancini; Sean W Hayes; Pamela M Hartigan; William S Weintraub; Robert A O'Rourke; Marcin Dada; John A Spertus; Bernard R Chaitman; John Friedman; Piotr Slomka; Gary V Heller; Guido Germano; Gilbert Gosselin; Peter Berger; William J Kostuk; Ronald G Schwartz; Merill Knudtson; Emir Veledar; Eric R Bates; Benjamin McCallister; Koon K Teo; William E Boden Journal: Circulation Date: 2008-02-11 Impact factor: 29.690