In the ISCHEMIA Trial, 5179 patients with moderate or severe myocardial ischemia were randomized equally into two groups based on initial management strategy: initial invasive strategy (angiography and revascularization when feasible) and medical therapy, or initial conservative strategy (medical therapy alone and angiography if medical therapy faile
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Coronary Disease - PCI
Percutaneous Coronary Angioplasty Versus Coronary Artery Bypass Grafting in Treatment of Unprotected Left Main Stenosis (NOBLE): A Prospective, Randomised, Open-Label, Non-Inferiority Trial
January 10, 2020
''CABG was significantly better than PCI (p=0·0066........''
The Discussion Continues as the EXCEL Authors Respond to EACTS's Withdrawal of Support of the LMS Chapter of the EACTS/ESC Revascularization Guidelines
December 19, 2019
Following the withdrawal of the support of EACTS for the left main stem chapter of the EACTS/ESC Chapter of the revascularisation guidelines following the BBC Newsnight documentary of this, and the withdrawal of Professor David Taggart as an author of the EXCEL trial published in the NEJM, the EXCEL trial authors have published a very robust defence
November 18, 2019
An editorial related to a recent randomized controlled trial suggesting a striking benefit of anti-inflammatory secondary prevention after recent myocardial events.
November 6, 2019
In this randomized trial, percutaneous coronary intervention and CABG had equivalent outcomes for the composite of death, stroke, or myocardial infarction at five years for patients with left main disease of low or intermediate anatomical complexity.
October 19, 2019
Quite interesting to see that the incidence of revascularisation after multivessel PCA (the additional element on the second co-primary outcome) appears to have occured in more than 1% of the patients within three years...
October 18, 2019
Using data from the FREEDOM (Future Revascularizaiton Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease) trial, the authors developed an 8 variable model that predicts individual risk of major acute cardiovascular events in diabetic patients with multivessel disease.
The Gender Gap in ACS: Sex-Specific Thresholds of High-Sensitivity Troponin in Patients With Suspected Acute Coronary Syndrome
October 15, 2019
Using gender specific thresholds for abnormalities in cardiac troponin I, the rate of injury among women increased by 42%. This did not translate into improved management of women, who remained about half as likely to undergo revascularization, receive dual antiplatet therapy, or undergo other interventions.
CABG Improves Outcomes in Patients With Ischemic Cardiomyopathy: 10-Year Follow-Up of the STICH Trial
September 14, 2019
This study reports ten year outcomes of the STICH trial. Comparing CABG to medical therapy groups, the authors note that CABG reduced all cause, cardiovascular, and heart failure hospitalizations. This included time-to-first and recurrent events. This was due to fewer total cardiovascular hospitalizations, the majority due to heart failure.
September 3, 2019
Remote ischemic preconditioning did not influence 12-month survival or readmission rates in a randomized trial involving more than 5,400 patients undergoing percutaneous coronary intervention after ST-segment elevation MI.