|Title:||A patient with stable angina and mild ischemia: Do I have the COURAGE not to stent the lesion?|
|Citation:||HEART AND METABOLISM, n.78, p.24-27, 2019|
|Abstract:||For many years, physicians worked on the assumption of a linear, straightforward link: angina - myocardial ischemia - coronary stenosis; therefore, it also seemed straightforward that to treat angina, we should tackle the culprit element, coronary stenosis, by fixing it with a stent. Advances in our understanding of the complex, multifactorial process leading to myocardial ischemia allowed us to appreciate that coronary stenosis is just one among many elements concurring to provoke myocardial ischemia. Moreover, clinical trials that challenged the “PCI-first approach” in the management of patients with stable angina demonstrated unequivocally that, for patients with nonlimiting symptoms, a run with a combination of antianginal drugs and disease-modifying agents could be safely offered before considering a myocardial revascularization procedure. Based on those premises, we present a clinical case that highlights the role of optimal medical therapy (OMT) in the management of a patient with stable angina as the initial therapeutic strategy as opposed to immediate PCI strategy. © 2019 Les Laboratoires Seriver. All rights reserved.|
|Appears in Collections:|
Artigos e Materiais de Revistas Científicas - HC/InCor
Artigos e Materiais de Revistas Científicas - LIM/13
Artigos e Materiais de Revistas Científicas - ODS/03
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