Percutaneous Coronary Intervention Versus Conservative Therapy in Nonacute Coronary Artery Disease

When I sat down to do this edition of the Updates, it was truly not in my mind to beat up Evidence Based Medicine.  I think the concept is wonderful, but the problem is that few practicing physicians actually read the literature to find out what the research says they’re supposed to be doing!!  With the reduction in the number of open heart surgeries, cardiovascular specialists new bread and butter is the PCI procedure (angioplasty, stents).  But, while this is only one study, it was rather large and showed no survival benefits with this procedure over standard nonsurgical care.  And, quite frankly, standard nonsurgical cardiology care is WAY below the research.  The evidence supporting prevention and managing insulin resistance is, quite frankly, staggerring.  And yet, the AZ Heart Institute here in AZ, HAS NO ONE DOING PREVENTION.  If that ain’t a kick in the gluts I’m not quite sure what would be.  So, the bottom line is that we have a new, expensive procedure generating lots of money but not saving lives when compared to substandard nonsurgical intervention.  Compare this procedure to a good lifestyle modification program and the results would be akin to a Micheal Jackson vs Mike Tyson fight…

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James Bogash

For more than a decade, Dr. Bogash has stayed current with the medical literature as it relates to physiology, disease prevention and disease management. He uses his knowledge to educate patients, the community and cyberspace on the best way to avoid and / or manage chronic diseases using lifestyle and targeted supplementation.