Waiting For ISCHEMIA: Why Won’t Cardiologists Enroll Patients?

One of the most important unanswered questions in medicine today– the best treatment for stable ischemic heart disease– may never get a satisfactory answer because cardiologists are unwilling to enter their patients in a clinical trial. One major reason why the question is urgent: about a third of the 1 million PCI procedures performed each year in the…

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Questions About President George W. Bush’s Stent

Former President George W. Bush received a stent today at Texas Health Presbyterian Hospital. Here is the statement from Bush’s office: During President George W. Bush’s annual physical examination at the Cooper Clinic in Dallas yesterday, a blockage was discovered in an artery in his heart. At the recommendation of his doctors, President Bush agreed to have a stent…

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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…

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Has COURAGE been vindicated?

The ACC, the AHA, and a whole alphabet soup worth of other cardiovascular organizations (SCAI, STS, AATS, ASNC, ASE, HFSA SCCT) have published (or in some cases just endorsed) a report, called the ACCF/SCAI/STS/AATS/AHA/ASNC 2009 Appropriateness Criteria for Coronary Revascularization. The report  will probably provide comfort to those who were big supporters of COURAGE. I’m guessing…

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