Podcast 564:  Cardiac Ischemia Management Update - The Emergency Medical Minute

Podcast 564:  Cardiac Ischemia Management Update

Contributor: Nick Tsipis, MD

Educational Pearls:

  • Recent randomized controlled trial compared early intervention (PCI/CABG) to medical management for those diagnosed with moderate to severe cardiac ischemia on stress testing
  • Primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest
  • Secondary outcome was death from cardiovascular causes or myocardial infarction.
  • The study reported that patients who had more aggressive invasive procedures early on in treatment had a 2% increase in poor outcomes in the immediate period after intervention (6 months) but long term had a 2% decrease in poor outcomes.
  • Overall the mortality was essentially identical between the two groups


1) Maron, D.J., et al. Initial Invasive or Conservative Strategy for Stable Coronary Disease. N Engl J Med. 2020 Apr 9;382(15):1395-1407. doi: 10.1056/NEJMoa1915922. Epub 2020 Mar 30.

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