title: Effect of Percutaneous Coronary Intervention on Survival in Patients with Stable Ischemic Heart Disease.
abstract: This study aims to determine if percutaneous coronary intervention (PCI) does improve survival in stable ischemic heart disease (SIHD).
  
  
  
  The International Study of Comparative Health Effectiveness with Medical and Invasive Approaches (ISCHEMIA) trial will evaluate patients with moderate to severe ischemia and will be the largest randomized trial of an initial management strategy of coronary revascularization (percutaneous or surgical) versus optimal medical therapy alone for SIHD. Although the ISCHEMIA trial may show a benefit with upfront coronary revascularization in this high-risk population, cardiac events after PCI are largely caused by plaque rupture in segments outside of the original stented segment. Furthermore, given the robust data from prior randomized trials, which showed no survival benefit with PCI, and the likelihood that the highest risk patients in ISCHEMIA will be treated with surgery, it is unlikely that the ISCHEMIA trial will show a survival benefit particular to PCI.
  
  
  
  Although PCI relieves symptoms, the evidence base indicates that it does not prolong survival in SIHD.
authors.affiliation: Department of Medicine Division of Cardiology New York VA Healthcare Network and New York University School of Medicine, 423 East 23rd Street, New York, NY, 10010, USA.
authors.forename: Francisco
authors.initials: F
authors.lastname: Ujueta
authors.affiliation: Department of Medicine Division of Cardiology New York VA Healthcare Network and New York University School of Medicine, 423 East 23rd Street, New York, NY, 10010, USA.
authors.forename: Ephraim N
authors.initials: EN
authors.lastname: Weiss
authors.affiliation: Department of Medicine Division of Cardiology New York VA Healthcare Network and New York University School of Medicine, 423 East 23rd Street, New York, NY, 10010, USA.
authors.forename: Binita
authors.initials: B
authors.lastname: Shah
authors.affiliation: Department of Medicine Division of Cardiology New York VA Healthcare Network and New York University School of Medicine, 423 East 23rd Street, New York, NY, 10010, USA. Steven.Sedlis@va.gov.
authors.forename: Steven P
authors.initials: SP
authors.lastname: Sedlis
mesh_terms: D001026:Coronary Artery Bypass; D006801:Humans; D015201:Meta-Analysis as Topic; D017202:Myocardial Ischemia / Q000601:surgery*; D062645:Percutaneous Coronary Intervention; D016032:Randomized Controlled Trials as Topic; D012107:Research Design; D012720:Severity of Illness Index; D016896:Treatment Outcome
keywords: Coronary artery bypass grafting; Long-term survival; Optimal medical therapy; Percutaneous coronary intervention; Stable ischemic heart disease