Coronary artery disease remains very common, with management during an acute episode of chest pain clearly favoring intervention with balloon treatment, stenting, or other aggressive therapies. But for patients with stable disease, there is more controversy
If a person has stable coronary artery disease (no chest pain) but testing demonstrates are area of reduced blood flow, is it necessary to treat them with stenting, or best to manage with medications. Often, when the cardiologist sees reduced bloodflow to an area of heart muscle, he gets something that my cardiology friend likes to call the ‘cardio-stenotic reflex’–this is a reflexive need to improve the blood supply by placing a coronary stent.
This recent recent JAMA study showed that medication treatment in these ‘stable’ situations is equal to placing coronary stents to improve blood flow, as demonstrated in 5 year follow-up of over 5,000 patietns.
http://www.jwatch.org/fw108217/2013/12/03/coronary-stenting-doesnt-hold-well-meta-analyses
META-ANALYSIS OF STENTING IN STABLE DISEASE WITH ISCHEMIA