November 19th, 2012
Comprehensive Guidelines for Stable Ischemic Heart Disease Released
Larry Husten, PHD
New comprehensive guidelines for the diagnosis and treatment of stable ischemic heart disease have been released by the ACCF/AHA Task Force on Practice Guidelines.
August 28th, 2012
FAME 2: Can FFR Save PCI from Medical Therapy?
Larry Husten, PHD
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 […]
January 10th, 2011
Have the COURAGE to Critique a Substudy
Harlan M. Krumholz, MD, SM
In this journal club, I compare the published data from an original trial with the authors’ conclusions in a substudy from that trial. Often, a substudy provides valuable insights that complement the initial trial findings. Sometimes, however, you need to look closely to identify the additional insight. Case in point: COURAGE. The Original COURAGE Trial As reported […]
November 12th, 2010
Time Out!
Brahmajee Kartik Nallamothu, MD, MPH
This week, JAMA published a commentary that Harlan Krumholz and I wrote about the growing use of ad hoc PCI and its implications for decision making about coronary revascularization. To cut to the chase, we believe that ad hoc PCI — the performance of a diagnostic cath and PCI in the same setting — makes […]
September 13th, 2010
Three-year SYNTAX Results: Sensible, Not Sensational
Richard A. Lange, MD, MBA
In SYNTAX, 1800 patients with multivessel and/or left main disease were randomized to CABG or PCI with DES after a surgeon and an interventional cardiologist reviewed the coronary angiogram and agreed that either procedure was appropriate. (See the CardioExchange News blog for more study information.) The SYNTAX 3-year results show that patients with a low SYNTAX […]
September 8th, 2010
“Cath Lab, We Have A Problem”?
Richard A. Lange, MD, MBA
According to a recently published study, a huge disconnect apparently exists between patients’ and cardiologists’ beliefs about the benefits of PCI. The patients had been referred for coronary angiography and possible PCI, had discussed PCI with a physician, and had provided informed consent. Most patients (~88%) believed that PCI would reduce their risks of MI, whereas most […]
September 7th, 2010
Patients Still Overestimate Benefits of Elective PCI
Larry Husten, PHD
Patients who undergo elective PCI continue to overestimate the procedure’s benefits, according to a small study published in the Annals of Internal Medicine. Michael Rothberg and colleagues surveyed 153 patients and 27 cardiologists at a single academic center and found that 88% of the patients thought PCI would reduce their risk for MI and 82% […]