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Comment & Response |

Treatment of Patients With Stable Ischemic Heart Disease—Reply

Tamar S. Polonsky, MD, MSCI1; Ron Blankstein, MD2
[+] Author Affiliations
1University of Chicago, Chicago, Illinois
2Brigham and Women’s Hospital, Boston, Massachusetts
JAMA. 2016;315(17):1906-1907. doi:10.1001/jama.2016.0695.
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In Reply Drs Civeira and Mateo-Gallego question the referral of a stable patient for CABG surgery. The patient we described had severe myocardial ischemia and more than 70% obstructive disease in all 3 coronary arteries—findings that provide a class I indication for CABG surgery to improve survival.1 Results from trials such as COURAGE and FAME 2 (Fractional Flow Reserve vs Angiography for Multivessel Evaluation 2) demonstrate that many patients with stable ischemic heart disease can be treated with optimal medical therapy alone but do not fully address how to manage the care of patients with severe ischemia.2,3


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May 3, 2016
Fernando Civeira, MD, PhD; Rocío Mateo-Gallego, PhD
1Hospital Universitario Miguel Servet, IIA Aragon, Zaragoza, Spain
JAMA. 2016;315(17):1904-1905. doi:10.1001/jama.2016.0680.
May 3, 2016
Joseph A. Ladapo, MD, PhD
1Departments of Medicine and Population Health, New York University School of Medicine, New York
JAMA. 2016;315(17):1905. doi:10.1001/jama.2016.0683.
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