[Catheter-based intervention therapies for ischemic heart disease].
Since the introduction of drug eluting stents (DES), the problem of restenosis, which had been an issue with percutaneous coronary intervention(PCI) for many years, has been overcome. Now that we understand the advantages and disadvantages of each device, the most important issue is whether or not the long term prognosis is better after PCI than after coronary artery bypass grafting (CABG). Comparing the evidence for PCI and CABG from this perspective has shown that PCI is still inferior with respect to the long term prognosis, emphasizing the importance of secondary prevention (lifestyle modification/drug therapy). By implementing OMT (Optimal Medical Therapy), which combines lifestyle modification with evidence-based and individualized drug therapy, to augment PCI, the long term prognosis may reach equivalence with that after CABG, and this will represent the start of an era in which coronary revascularization can be accomplished by minimally invasive treatment in the true sense. Now that the problem of restenosis has been overcome with the adoption of DES, the emphasis will be on secondary prevention in the future.
Department of Cardiology, Kokura Memorial Hospital, Kitakyushu 802 8555, Japan. hiroyokoi@circus.ocn.ne.jp
Hiroyoshi
H
Yokoi
D062906:Cardiac Catheters; D001026:Coronary Artery Bypass / Q000379:methods; D003324:Coronary Artery Disease / Q000601:surgery*; D054855:Drug-Eluting Stents; D006801:Humans; D017202:Myocardial Ischemia / Q000601:surgery*; D016896:Treatment Outcome