Stable Coronary Artery Disease: When is Percutaneous Coronary Intervention Indicated?

Authors

  • Demosthenes G. Katritsis

DOI:

https://doi.org/10.2015/hc.v1i1%20sup.66

Keywords:

coronary artery disease, coronary angioplasty, coronary stenting, percutaneous coronary intervention, coronary bypass surgery, acute coronary syndromes, ischemic heart disease, myocardial infarction

Abstract

In patients with chronic coronary artery disease (CAD) and good left ventricular function, percutaneous coronary intervention (PCI) does not confer any clear benefit in terms of hard long-term clinical outcomes, such as mortality, myocardial infarction or the need for subsequent revascularization, as compared with medical conservative treatment. Indeed, a meta-analysis of early data from 6 randomised controlled trials has showed convincingly that PCI improves anginal symptoms compared to conservative management, but there has been limited evidence on the effect of PCI on hard clinical outcomes. At the same time, the early fear of increased need for revascularization after PCI is probably not warranted. By comparing the benefits against cost considerations, it seems that many percutaneous interventions that are currently performed in patients with non-acute CAD are probably not justified.

Downloads

Issue

Vol. 1 No. 1 sup (2006)

Section

Cardiology Update 2006

License

Authors who publish with this journal agree to the following terms:

a. Authors retain copyright and grant the journal right of first publication with the work simultaneously licensed under a Creative Commons Attribution License that allows others to share the work with an acknowledgement of the work's authorship and initial publication in this journal.

b. Authors are able to enter into separate, additional contractual arrangements for the non-exclusive distribution of the journal's published version of the work (e.g., post it to an institutional repository or publish it in a book), with an acknowledgement of its initial publication in this journal.

c. Authors are permitted and encouraged to post their work online (e.g., in institutional repositories or on their website) prior to and during the submission process, as it can lead to productive exchanges, as well as earlier and greater citation of published work (See The Effect of Open Access).