Torosoff M T, Sidhu M S, Boden W E
Albany Medical Center, Albany, NY 12208, USA.
Herz. 2013 Jun;38(4):382-6. doi: 10.1007/s00059-013-3824-0.
In patients with stable ischemic heart disease (SIHD), myocardial revascularization should be performed to either improve survival or improve symptoms and functional status among patients who are not well controlled with optimal medical therapy (OMT). A general consensus exists on the core elements of OMT, which include both lifestyle intervention and intensive secondary prevention with proven pharmacotherapies. By contrast, however, there is less general agreement as to what constitutes the optimal approach to revascularization in SIHD patients. The COURAGE and FAME 2 randomized trials form the foundation of the current clinical evidence base and raise the important question: "What is the impact of myocardial ischemia on myocardial revascularization in stable ischemic heart disease?"
对于稳定型缺血性心脏病（SIHD）患者，应进行心肌血运重建，以改善生存率，或改善症状及功能状态，这些患者在接受最佳药物治疗（OMT）后病情仍未得到良好控制。对于OMT的核心要素已达成普遍共识，其中包括生活方式干预以及采用经证实的药物疗法进行强化二级预防。然而，相比之下，对于SIHD患者的最佳血运重建方法尚无普遍共识。COURAGE试验和FAME 2随机试验构成了当前临床证据基础，并提出了一个重要问题：“心肌缺血对稳定型缺血性心脏病患者心肌血运重建有何影响？”
