Posts Tagged ‘COURAGE’

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February 4th, 2015

Clinical Significance of Non-IRA Disease in STEMI Patients

Beat Meyer wonders whether and how an observed association between the presence of non-IRA lesions and increased mortality in STEMI patients will affect treatment decisions.


January 27th, 2014

How “Compelling” Are Coronary Anatomy and Ischemic Burden When Considering an Invasive Strategy?

William E. Boden discusses his research group’s post hoc analysis of data from the COURAGE trial.


December 3rd, 2013

Stents Lose in Comparisons with Surgery and Medical Therapy

Despite the enormous increase in the use of stents in recent decades, there is little or no good evidence comparing their use to the alternatives of CABG surgery or optimal medical therapy in patients also eligible for these strategies. Now two meta-analyses published in JAMA Internal Medicine provide new evidence that the alternatives to PCI […]


August 19th, 2013

Look Before Leaping to Conclusions About Bush’s Stent

Ajay Kirtane shares his thoughts on the publicity surrounding Bush’s stent and what it means for the public perception of PCI.


August 28th, 2012

FAME 2: Can FFR Save PCI from Medical Therapy?

Two sharply divergent views have developed about the value of fractional flow reserve (FFR) in PCI. FFR advocates think the new technology can help identify ischemic lesions that will benefit from PCI, thereby helping to salvage or enhance the reputation of PCI. FFR skeptics think that optimal medical therapy is still the preferred option for most […]


February 27th, 2012

Meta-Analysis Finds No Advantages for PCI Over Medical Therapy in Stable Patients

Patients with stable coronary artery disease (CAD) today do no better with stents than with medical therapy, according to a new meta-analysis published in the Archives of Internal Medicine. Kathleen Stergiopoulos and David Brown identified 8 trials with 7,229 patients comparing stents to medical therapy in which stents were used in the majority of PCI cases. ”By limiting the […]


August 9th, 2011

Will ISCHEMIA Tell Us More than COURAGE? PART II: Banking on Eight Years of Equipoise

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(Continued from Part I: Aiming to Beat Bias with Blinding) On August 1, 2011, the Langone Medical Center at New York University announced that the National Heart, Lung, and Blood Institute has provided a grant to fund the ISCHEMIA study of an invasive strategy versus optimal medical management in patients with stable coronary artery disease and […]


August 8th, 2011

Will ISCHEMIA Tell Us More Than COURAGE? Part I: Aiming to Beat Bias with Blinding

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On August 1, 2011, New York University announced that the National Heart, Lung, and Blood Institute would fund the ISCHEMIA study of an invasive strategy versus optimal medical management in patients with stable coronary artery disease and moderate-to-severe ischemia. We welcome the members of the study Executive Committee, chaired by Dr. Judith Hochman, to answer […]


August 1st, 2011

Going Beyond COURAGE: NHLBI Funds the ISCHEMIA Study

The NHLBI has awarded an $84 million grant to fund the International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA). The trial will randomize 8,000 patients with stable ischemic heart disease and moderate-to-severe ischemia. Two different treatment strategies will be compared: An invasive strategy, consisting of early routine cardiac catheterization followed by revascularization […]


July 29th, 2011

Less May Be More, But Stents Are Neither Good Nor Bad

A few days ago, the distinguished healthcare writer Shannon Brownlee wrote a provocative blog post  about the overuse of stents. A key piece of evidence that she used was a paper co-authored by Grace Lin and Rita Redberg, in which focus groups of cardiologists cheerfully admitted that they would give stents to hypothetical patients who were, according to the current guidelines, not […]