Towards evidence-based percutaneous coronary intervention: the René Laënnec lecture in clinical cardiology.
Percutaneous coronary intervention (PCI) has matured from a pioneering adventure focused on feasibility to a major sub-specialty delivering real clinical results to patients. Despite delivering reductions in mortality and morbidity in the field of acute coronary syndrome and overcoming in-stent restenosis, several challenges still remain. Firstly, we need to adhere to practices supported by established trials: data relating to PCI in stable angina and late reopening of occluded infarct-related vessels suggest that this is not always the case. Secondly, we must develop new trials asking clinically relevant questions in 'real-world' populations that are focused on patient-based outcomes. Finally, given the current global financial crisis, it is now more important than ever that we demonstrate cost-effectiveness in our clinical practice. In these turbulent times, we discuss the challenges ahead for PCI in its journey towards evidence-based practice.
Hôpital Bichat, Assistance Publique-Hôpitaux de Paris, Paris,  France.
Patrick A
PA
Calvert
P Gabriel
PG
Steg
D054058:Acute Coronary Syndrome / Q000628:therapy*; D060050:Angina, Stable / Q000628:therapy; D015906:Angioplasty, Balloon, Coronary / Q000191:economics / Q000379:methods* / Q000639:trends; D023903:Coronary Restenosis / Q000517:prevention & control; D003362:Cost-Benefit Analysis; D019317:Evidence-Based Medicine; D005544:Forecasting; D006801:Humans; D009203:Myocardial Infarction / Q000628:therapy; D009204:Myocardial Revascularization / Q000379:methods; D016032:Randomized Controlled Trials as Topic