title: COURAGE under fire: on the management of stable coronary disease.
abstract: The COURAGE (Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation) trial showed that coronary interventional procedures added little to optimal medical therapy with respect to the long-term outcome of patients with stable coronary disease when used as initial therapy. Detractors opine that: 1) the trial was unrealistic in design and the findings were not unexpected; 2) the use of coronary interventional procedures was suboptimal; and 3) the results of COURAGE are not applicable to current clinical practice. We herein reevaluate the evidence with regard to each of these points, and conclude that COURAGE indeed provides relevant new information to assist the practitioner in the appropriate management of patients with stable coronary disease.
authors.affiliation: Division of Cardiology, Cedars-Sinai Medical Center, and the David Geffen School of Medicine, University of California, Los Angeles, California, USA. gadiamond@pol.net
authors.forename: George A
authors.initials: GA
authors.lastname: Diamond
authors.forename: Sanjay
authors.initials: S
authors.lastname: Kaul
mesh_terms: D000789:Angina, Unstable / Q000628:therapy*; D015906:Angioplasty, Balloon, Coronary; D017023:Coronary Angiography; D003327:Coronary Disease / Q000628:therapy*; D006760:Hospitalization; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy; D016032:Randomized Controlled Trials as Topic