Stable Ischemic Syndrome
Sunday, April 3, 4:45-6:00 PM

Unprotected left main PCI is receiving much attention, primarily to determine if it is as safe as an operative procedure. The truth is, according to ACC data, it is rarely performed in the U.S. When it is, however, the outcomes for the elderly are not that good. Having this type of information that comes from a national registry helps to inform best practices.

Part of the trend toward a more personalized approach to medicine includes various risk prediction scores for groups of patients. The SYNTAX score helped to stratify the risk between PCI and bypass surgery in patients with complex coronary disease.

Now, investigators from the COURAGE trial have designed a COURAGE Risk Score to help stratify risk in patients with stable ischemic heart disease. This is another example of extrapolating data from a carefully designed trial and using it in such a way that extends the benefits of the trial.

And finally, by pooling data from four trials, researchers have determined that the everolimus stent is superior to the paclitaxel stent in unstable as well as stable CAD patients, with a particular benefit in reducing stent thrombosis.

Oral contributions represent diligent work from teams of investigators who are generally stretching the bounds of medical practice. ACC.11 attendees would do well to take in a few of these sessions, especially the one noted here.

Speaker information

  • J. Matthew Brennan, MD, et al, Duke Clinical Research Institute, Durham, N.C. -- Characteristics and Outcomes of Percutaneous Revascularization of Unprotected Left Main Coronary Artery Stenosis in the United States: Results from the National Cardiovascular Data Registry, 2004-2008
  • William E. Boden, MD, et al, University at Buffalo, Buffalo, N.Y. -- A New Risk Prediction Tool to Assess Long-Term Prognosis in Patients with Stable Ischemic Heart Disease (SIHD): The "COURAGE Risk Score"
  • Yu Kataoka, MD, et al, Cleveland Clinic -- Greater Progression of Coronary Atherosclerosis in African-American Patients despite the Use of Established Medical Therapies
  • David Planer, MD, et al, Columbia University Medical Center, New York City -- Comparison of the Everolimus-Eluting and Paclitaxel-Eluting Stents in Patients with Acute and Stable Coronary Syndromes. Results from the SPIRIT II, III, IV and COMPARE Trials