The Courage Trial - An Interview with Dr. Alan Shah
About this Video
Dr.Roshini Rajapaksa is an Assistant Professor of Medicine at NYU School of Medicine, and a practing internist and gastroenterologist. She is a regular television medical contributor and has appeared as an expert on CNN, MSNBC, ABC, and Fox News Channel.
In this interview, Dr. Alan Shah, an attending cardiologist at NYU Medical Center discusses the merits, flaws, and impact of the new Courage trial. This study compared percutaneous coronary intervention (PCI) to optimal medical therapy in the treatment of stable coronary artery disease (CAD), and found similar outcomes with both treatments.
While there have been smaller studies with similar findings, Dr.Shah found this study to be impressive because it involved a large number of patients (2,287) and because aggressive medical therapy was used.
Dr. Shah discussed the three arms of medical therapy for CAD which are 1)TLC or total lifestyle changes which include weight loss, diet, exercise, and smoking cessation, 2) controlling blood pressure, and 3) managing cholesterol.
He cautioned that we cannot generalize these results to all patients with CAD, since the vast majority were excluded because of other cardiac problems, and because women, minorities, and diabetic patients were under-represented in the study.
He discussed the importance of the discussion between patient and doctor before undergoing a cardiac catheterization, so a plan is agreed upon to deal with the many situations that may arise during the procedure.
He also discussed new techniques for assessing blockages of cardiac vessels including CT angiography where a CT scan is used as a non-invasive method of looking at the heart vessels.
He reminded us that in the medically treated group in this trial, 1/3 of patients eventually needed PCI, which needs to be considered when interpreting the results.
Finally, he said that after reading this study, when faced with a similar patient, he would advise a trial aggressive medical therapy prior to recommending cardiac catheterization.
Discussion
No comments for “The Courage Trial - An Interview with Dr. Alan Shah”
Post a comment