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Current Indications for Stenting: Symptoms or Survival CME - PubMed

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Current Indications for Stenting: Symptoms or Survival CME

Suzanne V Arnold. Methodist Debakey Cardiovasc J. 2018 Jan-Mar.

Abstract

The major goals of treating ischemic heart disease are to reduce angina, improve quality of life, and ultimately reduce mortality. While medical therapy can effectively address these aims, there is still much research and debate about the role of percutaneous coronary intervention in the treatment spectrum-specifically, whether or not stenting prolongs life or simply treats symptoms without impacting survival. The data supporting revascularization for survival benefit came from patients who underwent bypass graft surgery prior to the introduction of effective medical management. Although both physicians and patients continue to believe in the life-saving ability of coronary stenting, little data exist to support this belief outside of when used during an acute myocardial infarction. Strategy trials designed to test the benefit of coronary stenting have limitations that have curbed physicians' willingness to accept the results, but they provide the best evidence for how to optimally manage these patients. In this article, we explore the data supporting the use of coronary stenting for various indications and the questions that remain to be answered.

Keywords: angina; coronary artery disease; coronary stenting; ischemic heart disease; percutaneous coronary intervention; revascularization.

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Conflict of interest statement

Conflict of Interest Disclosure: The author has completed and submitted the Methodist DeBakey Cardiovascular Journal Conflict of Interest Statement and none were reported.

Figures

Figure 1.
Figure 1.

The role of treatments for coronary artery disease. MI: myocardial infarction; QOL: quality of life

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References

    1. Baigent C, Blackwell L, Collins R, . et al. .; Antithrombotic Trialists' (ATT) Collaboration Aspirin in the primary and secondary prevention of vascular disease: collaborative meta-analysis of individual participant data from randomised trials. Lancet. 2009. May 30; 373 9678: 1849– 60. - PMC - PubMed
    1. Yeh RW, Secemsky EA, Kereiakes DJ, . et al. .; DAPT Study Investigators Development and Validation of a Prediction Rule for Benefit and Harm of Dual Antiplatelet Therapy Beyond 1 Year After Percutaneous Coronary Intervention. JAMA. 2016. April 26; 315 16: 1735– 49. - PMC - PubMed
    1. Baigent C, Keech A, Kearney PM, . et al. .; Cholesterol Treatment Trialists' (CTT) Collaborators Efficacy and safety of cholesterol-lowering treatment: prospective meta-analysis of data from 90,056 participants in 14 randomised trials of statins. Lancet. 2005. October 8; 366 9493: 1267– 78. - PubMed
    1. Amin AP, Bachuwar A, Reid KJ, . et al. Nuisance bleeding with prolonged dual antiplatelet therapy after acute myocardial infarction and its impact on health status. J Am Coll Cardiol. 2013. May 28; 61 21: 2130– 8. - PMC - PubMed
    1. Wilson SR, Scirica BM, Braunwald E, . et al. Efficacy of ranolazine in patients with chronic angina observations from the randomized, double-blind, placebo-controlled MERLIN-TIMI (Metabolic Efficiency With Ranolazine for Less Ischemia in Non-ST-Segment Elevation Acute Coronary Syndromes) 36 Trial. J Am Coll Cardiol. 2009. April 28; 53 17: 1510– 6. - PubMed

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