Affiliation:
1. Department of Interventional Cardiology, National Institute of Cardiology, Mexico City, Mexico; The American British Cowdray Medical Center, Mexico City, Mexico
2. The American British Cowdray Medical Center, Mexico City, Mexico
Abstract
During the past decade, the treatment of choice for chronic coronary syndromes (CCS) has been a contentious issue. Whether revascularisation, either percutaneous or surgical, or optimal medical therapy, offers better prognosis in terms of mortality, MI, and symptom relief, has yet to be confirmed. The long-awaited and recently published International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial randomised more than 5,000 patients into a revascularisation plus optimal medical therapy group and an optimal medical therapy alone group. The authors analyse the trial, with particular emphasis on the incidence of MI. They propose a patient-centred approach to incorporate the results of the ISCHEMIA trial into daily practice and determine the best treatment strategy for patients with CCS.
Subject
Cardiology and Cardiovascular Medicine
Reference16 articles.
1. Boden WE, O’Rourke RA, Teo KK, et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007;356:1503–16. https://doi.org/10.1056/NEJMoa070829; PMID: 17387127.
2. Dagenais GR, Lu J, Faxon DP, et al. Effects of optimal medical treatment with or without coronary revascularization on angina and subsequent revascularizations in patients with type 2 diabetes mellitus and stable ischemic heart disease. Circulation 2011;123:1492–500. https://doi.org/10.1161/CIRCULATIONAHA.110.978247; PMID: 21444887.
3. Stergiopoulos K, Brown DL. Initial coronary stent implantation with medical therapy vs medical therapy alone for stable coronary artery disease: meta-analysis of randomized controlled trials. Arch Intern Med 2012;172:312–9. https://doi.org/10.1001/archinternmed.2012.2215; PMID: 22371919.
4. Maron DJ, Hochman HR, Reynolds S, et al. Initial invasive or conservative strategy for stable coronary disease. N Engl J Med 2020;382:1395–407. https://doi.org/10.1056/NEJMoa1915922; PMID: 32227755.
5. Bangalore S, Gupta N, Généreux P, et al. Trend in percutaneous coronary intervention volume following the COURAGE and BARI-2D trials: Insight from over 8.1 million percutaneous coronary interventions. Int J Cardiol 2015;183:6–10. https://doi.org/10.1016/j.ijcard.2015.01.053; PMID: 25662046.
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