Cardiology>>>>>Ischaemic heart disease
Question 114#

A 55-year-old man presents since 3 months typical chest pain at moderate exertion. The angiography revealed single-vessel disease. An optimal therapy has been started; what is the benefit of a treatment with PCI of the culprit lesion?

A. PCI would reduce the risk of death, MI, or other major CV events when added to optimal medical therapy (OMT)
B. PCI may reduce the episodes of angina in the presence of moderate-tosevere ischemia at stress single-photon emission computed tomography (SPECT) but not the risk of death, MI, or other major CV events when added to OMT
C. PCI would not reduce the risk of death, MI, angina episodes, or other CV events when added to OMT
D. The benefit of revascularization in patients with stable angina and ischemia detected on SPECT is independent of the extent of ischemia
E. Selective ischemia-driven PCI approach should be avoided, as thus not improved clinical outcomes

Correct Answer is B

Comment:

PCI may reduce the episodes of angina in the presence of moderate-tosevere ischemia at stress single-photon emission computed tomography (SPECT) but not the risk of death, MI, or other major CV events when added to optimal medical therapy. The COURAGE trial compared OMT alone or in combination with PCI as an initial management strategy in patients with stable CAD. Although the addition of PCI to OMT reduced the prevalence of angina, especially in case of moderate-to-severe ischemia detected by SPECT, it did not reduce long-term rates of death, nonfatal MI, and hospitalization for ACSs.