CardioExchange Archive

September 3rd, 2014

FAME 2 at 2 Years: Better with Time?

CardioExchange Editors, Staff

The CardioExchange editors ask whether the 2-year findings from FAME 2 are more compelling than the 7-month findings.

---

October 4th, 2012

Beta-Blockers May Not Work as Well as We Thought: So What Does “Optimal Medical Therapy” Really Mean?

Ajay J Kirtane, MD, SM

Proponents of optical medical therapy believe that the benefits of coronary revasculartion in stable ischemic disease were established in outdated studies. But if beta blockers aren’t very effective, is optimal therapy just aspirin and a statin?

---

May 18th, 2012

FAME II: Another Study Abides in Infamy

Richard A. Lange, MD, MBA and L. David Hillis, MD

In FAME II, a prospective study conducted at 28 centers in Europe and the United States, >1200 patients with ischemia (as determined by fractional flow reserve [FFR]) were randomly assigned to receive (a) PCI (with a DES) and optimal medical therapy (OMT) or (b) OMT alone. The primary endpoint was a composite of death, myocardial infarction […]

---

February 27th, 2012

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

Larry Husten, PHD

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

Judith Hochman, L. David Hillis, MD and Richard A. Lange, MD, MBA

(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

Judith Hochman, L. David Hillis, MD and Richard A. Lange, MD, MBA

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

Larry Husten, PHD

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 […]

---

May 11th, 2011

Optimal Medical Therapy and the Lack of COURAGE

William Borden, MD and John Spertus, MD, MPH

We welcome William Borden and John Spertus to answer questions from CardioExchange Editor-in-Chief Harlan Krumholz about their JAMA paper showing that optimal medical therapy (OMT) for patients with coronary artery disease (CAD) did not receive a meaningful boost from the publication of the COURAGE trial, despite the trial’s clear message showing the benefits of OMT. Using […]

---