Copyright
©2014 Baishideng Publishing Group Co., Limited. All rights reserved.
World J Cardiol. Apr 26, 2014; 6(4): 130-139
Published online Apr 26, 2014. doi: 10.4330/wjc.v6.i4.130
Published online Apr 26, 2014. doi: 10.4330/wjc.v6.i4.130
Myocardial ischemia is a key factor in the management of stable coronary artery disease
Kohichiro Iwasaki, Department of Cardiology, Okayama Kyokuto Hospital, Okayama 703-8265, Japan
Author contributions: Iwasaki K contributed to the concept, design, and analysis and interpretation of the data; Iwasaki K also drafted the article, revised it critically for important intellectual content, and approved the final version to be published.
Correspondence to: Kohichiro Iwasaki, MD, Department of Cardiology, Okayama Kyokuto Hospital, 567-1 Kurata, Naka-ku, Okayama 703-8265, Japan. kiwasaki@kyokuto.or.jp
Telephone: +81-86-2763231 Fax: +81-86-2741028
Received: September 2, 2013
Revised: November 16, 2013
Accepted: March 3, 2014
Published online: April 26, 2014
Revised: November 16, 2013
Accepted: March 3, 2014
Published online: April 26, 2014
Core Tip
Core tip: Studies of myocardial perfusion imaging demonstrate that, for patients with moderate to severe ischemia, revascularization is the preferred therapy for survival benefit. For patients with no to mild ischemia, medical therapy is the main choice, and revascularization is associated with increased mortality probably because of worsened ischemia. Studies using fractional flow reserve demonstrate that ischemia-guided percutaneous coronary intervention (PCI) is superior to angiography-guided PCI, and the presence of ischemia is the key factor in decision-making for PCI. Thus, myocardial ischemia is a key factor in the management of patients with stable coronary artery disease.