The Paradigm Shift That Wasn ’ t: The ISCHEMIA Trial

By ANISH KOKA A recent email that arrived in my in-box a few weeks ago from an academic hailed the latest “paradigm shift” in cardiology as it relates to the management of stable angina.  (Stable angina refers to chronic,non-accelerating chest pain with a moderate level of exertion).  The points made in the email were as follows (the order of the points made are preserved): The financial burden of stress testing was significant ( 11 billion dollars per annum in the USA!)For stable CAD, medical treatment is critical.  We now have better medical treatments than all prior trials including ischemia. these include PCKS9 Inhibitor, SGLT2-i, GLP1 agonists Vascepa and othersCTA coronaries is by far the most important single test for evaluation of these patients” the paradigm of ischemia testing may have come to an end”For stable angina (not ACS!) in most cases, the decision on revascularization should be based only on symptoms alleviation (as no survival benefit). The general public should find it interesting, and not a random coincidence that the first point immediately gets to the financial burden of stress testing in a communication that is supposed to assess the level of evidence for the management of coronary artery disease. Imagine a cardiologist enters your exam room to talk about the chest pain you get every time you run up a flight of steps, and starts off the conversation with how much the societal cost of stress tests are.  The ...
Source: The Health Care Blog - Category: Consumer Health News Authors: Tags: Medical Practice Physicians Anish Koka cardiology ISCHEMIA trial Source Type: blogs