This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Citing articles on ISI (2)  • Contact me when this article is cited  Related Content  • Related letters  • Related articles  • Similar articles in this journal  Topic Collections  • Surgery  • Cardiovascular/ Cardiothoracic Surgery  • Vascular Surgery  • Cardiovascular Disease/ Myocardial Infarction  • Revascularization  • Alert me on articles by topic

David T. Nash, MD

Arch Intern Med. 2005;165:2587-2589.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

INTRODUCTION

More than 1 million angioplasties and coronary bypass procedures are performed in the United States every year.¹ Many patients—and their physicians as well—believe that such procedures are the best way to prevent heart attacks and to prolong survival. Actually, as Forrester and Shah² argued as early as 1997, performing such invasive procedures immediately after making a diagnosis of stable coronary artery disease (CAD) provides little or no long-term mortality benefit over medical therapy. Additional evidence from a number of more recent studies, as reviewed below, suggests that medical treatment of low-risk stable CAD (ie, only 1 or 2 major coronary arteries narrowed by >50%, an ejection fraction >40%, and mild-to-moderate symptoms of angina pectoris) is as effective as percutaneous transluminal coronary angioplasty (PTCA) in preventing additional cardiovascular events.^3-5 Although angioplasty may provide more rapid symptomatic relief and is clearly appropriate for high-risk patients with poor symptom . . . [Full Text of this Article]

WHAT THE STUDIES SHOW

INSTITUTING A RISK-REDUCTION PROGRAM

FUTURE MEDICAL OPTIONS

CONCLUSIONS

AUTHOR INFORMATION

Author Affiliations: Syracuse Preventive Cardiology and Department of Medicine, State University of New York at Syracuse Health Sciences Center, Syracuse.

RELATED LETTERS

Good Outcomes in Coronary Artery Disease Without Invasive Procedures
Thomas B. Graboys and Bernard Lown
Arch Intern Med. 2006;166(12):1325.
EXTRACT | FULL TEXT  

Mechanism of Action of Ranolazine
Celeste Marx and Michael Sweeney
Arch Intern Med. 2006;166(12):1325-1326.
EXTRACT | FULL TEXT  

Mechanism of Action of Ranolazine—Reply
David Nash
Arch Intern Med. 2006;166(12):1326.
EXTRACT | FULL TEXT  

RELATED ARTICLES

Angioplasty Is Better Than Medical Therapy for Alleviating Chronic Angina Pectoris
Spencer B. King, III
Arch Intern Med. 2005;165(22):2589-2592.
EXTRACT | FULL TEXT  

Rebuttal
David T. Nash
Arch Intern Med. 2005;165(22):2592-2593.
EXTRACT | FULL TEXT  

Rebuttal
Spencer B. King, III
Arch Intern Med. 2005;165(22):2593-2594.
EXTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Good outcomes in coronary artery disease without invasive procedures.
Graboys and Lown
Arch Intern Med 2006;166:1325-1325.
FULL TEXT  

Mechanism of action of ranolazine.
Marx and Sweeney
Arch Intern Med 2006;166:1325-1326.
FULL TEXT