Elias B. Hanna

Practical Cardiovascular Medicine


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RJ, Levy WS, Buff L, et al. Prevention of nitrate tolerance with angiotensin converting enzyme inhibitors. Circulation 1991; 83: 1271–7.

      50 50. Watanabe, H, Kahihana, M, Ohtsuka, S, et al. Randomized, double-blind, placebo-controlled study of carvedilol on the prevention of nitrate tolerance in patients with chronic heart failure. J Am Coll Cardiol 1998; 32: 1194–200.

      51 51. Chaitman BR, Skettino SL, Parker JO, et al. Anti-ischemic effects and long-term survival during ranolazine monotherapy in patients with chronic severe angina. J Am Coll Cardiol 2004; 43: 1375–82.

      52 52. Chaitman BR, Pepine CJ, Parker JO, et al. Effects of ranolazine with atenolol, amlodipine, or diltiazem on exercise tolerance and angina frequency in patients with severe chronic angina. JAMA 2004; 291: 309–16.

      53 53. Morrow DA, Scirica BM, Karwatowska-Prokopczuk E, for the MERLIN-TIMI 36 Trial Investigators. Effects of ranolazine on recurrent cardiovascular events in patients with non-ST-elevation acute coronary syndromes: the MERLIN-TIMI 36 randomized trial. JAMA 2007; 297: 1775–83.

      54 54. Mega JL, Hochman JS, Scirica BM, et al. Clinical features and outcomes of women with unstable ischemic heart disease: observations from metabolic efficiency with ranolazine for less ischemia in non-ST-elevation acute coronary syndromes-thrombolysis in myocardial infarction 36 (MERLIN-TIMI 36). Circulation 2010; 121: 1809–17.

      55 55. Morrow DA, Scirica BM, Sabatine MS, et al. B-type natriuretic peptide and the effect of ranolazine in patients with non-ST-segment elevation acute coronary syndromes: observations from the MERLIN–TIMI 36 trial. J Am Coll Cardiol 2010; 55: 1189–96.

      56 56. Scirica BM, Braunwald E, Belardinelli L, et al. Relationship between nonsustained ventricular tachycardia after non-ST-elevation acute coronary syndrome and sudden cardiac death: observations from MERLIN-TIMI 36 randomized controlled trial. Circulation 2010; 122: 455–62.

      57 57. SPRINT Research Group. A randomized trial of intensive versus standard blood pressure control. N Engl J Med 2015; 373: 2103–16.

      58 58. HOPE Study Investigators. Effects of an angiotensin-converting-enzyme inhibitor, ramipril, on cardiovascular events in high-risk patients. N Engl J Med 2000; 342: 145–53. HOPE study.

      59 59. PEACE Trial Investigators. Angiotensin-converting-enzyme inhibition in stable coronary artery disease. N Engl J Med 2004; 351: 2058–68.

      60 60. Rouleau J, Warnica WJ, Baillot R, et al. Effects of angiotensin-converting enzyme inhibition in low-risk patients early after coronary artery bypass surgery. Circulation 2008; 117: 24–31.

      Revascularization (+ISCHEMIA references 19,20)

      1 61. Hachamovitch R, Hayes SW, Friedman JD, et al. Comparison of the short-term survival benefit associated with revascularization compared with medical therapy in patients with no prior coronary artery disease undergoing stress myocardial perfusion single photon emission computed tomography. Circulation 2003; 107: 2900–6.

      2 62. Mancini GB, Hartigan PM, Shaw LJ, et al. Predicting outcomes in the COURAGE trial: coronary anatomy versus ischemia. JACC Cardiovasc Interv 2014; 7: 195–201. Only anatomic burden and EF are predictor of death and MI, not ischemic burden. PCI did not improve outcomes regardless of anatomic burden or ischemia.

      3 63. Reynolds H. Relationships of ischemia severity and coronary artery disease extent with clinical outcomes in the ISCHEMIA trial. Presented at ACC. March 2020. Anatomic burden of disease is a strong predictor of death and cardiac outcomes, while ischemia was not an independent predictor of death and only marginally predicted MI. Mortality and MI were similar with invasive vs conservative strategy, regardless of the degree of ischemia severity or anatomic burden.

      4 64. Mancini GB, Hartigan PM, Bates ER, et al. Angiographic disease progression and residual risk of cardiovascular events while on optimal medical therapy. Observations from the COURAGE Trial. Circ Cardiovasc Interv 2011; 4: 545–52.

      5 65. Pijls NH, Fearon WF, Tonino PA, et al. Fractional flow reserve versus angiography for guiding percutaneous coronary intervention in patients with multivessel coronary artery disease: 2-year follow-up of the FAME study. J Am Coll Cardiol 2010; 56: 177–84.

      6 66. De Bruyne B, Pijls N, Kalesan B, et al. Fractional flow reserve-guided PCI versus medical therapy in stable coronary disease. N Engl J Med 2012; 367: 991–1001.

      7 67. Stone G.W., Maehara A., Lansky A.J., et al. PROSPECT Investigators A prospective natural-history study of coronary atherosclerosis. N Engl J Med 2011; 364: 226–235.

      8 68. Yusuf S, Zucker D, Peduzzi P, et al. Effect of coronary artery bypass surgery on survival: Overview of 10-year results from randomized trials by the Coronary Artery Bypass Surgery Trialists Collaboration. Lancet 1994; 344: 563.

      9 69. Velazquez EJ, Lee KL, Deja MA, et al.; STICH Investigators. Coronary-artery bypass surgery in patients with left ventricular dysfunction, N Engl J Med 2011; 364: 1607–16.

      10 70. Velazquez EJ, Lee KL, Jones RH, et al. Coronary-Artery Bypass Surgery in Patients with Ischemic Cardiomyopathy. N Engl J Med. 2016; 374(16):1511–1520.

      PCI vs. medical therapy (+ISCHEMIA references 19,20; FAME 2 references 28,65)

      1 71. Zellweger MJ, Kaiser C, Jeger R, et al. Coronary artery disease progression late after stent implantation. J Am Coll Cardiol 2012; 59: 793–9.

      2 72. Boden WE, O’Rourke RA, Teo KK, et al. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med 2007; 356: 1503–1516. COURAGE trial.

      3 73. Weintraub WS, Spertus JA, Kolm P, et al. Effect of PCI on quality of life in patients with stable coronary disease. N Engl J Med 2008; 359: 677–87.

      4 74. Frye RL, August P, Brooks MM, et al.; BARI 2D Study Group. A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med 2009; 360: 2503–15.

      5 75. Prasad A, Gersh BJ, Bertrand ME, et al. Prognostic significance of periprocedural versus spontaneously occurring myocardial infarction after percutaneous coronary intervention in patients with acute coronary syndromes. An analysis from the ACUITY trial. J Am Coll Cardiol 2009; 54: 477–86.

      6 76. Bangalore S. Relationship of CKD severity with clinical outcomes in the ISCHEMIA and ISCHEMIA-CKD trials. Presented at ACC, March 2020.

      7 77. Spertus JA, Jones PG, Maron DJ, et al. Health-status outcomes with invasive or conservative care in coronary disease. N Engl J Med 2020;382: 1408-1419. 136.

      CABG vs. PCI

      1 78. Wang JC, Normand SL, Mauri L, et al. Coronary artery spatial distribution of acute myocardial infarction occlusions. Circulation. 2004;110:278–284. +Also: Gibson CM, Kirtane AJ, Murphy SA, et al. Distance from the coronary ostium to the culprit lesion in acute ST-elevation myocardial infarction and its implications regarding the potential prevention of proximal plaque rupture. J Thromb Thrombolysis. 2003; 15:189–196.

      2 79. Detre KM, Lombardero MS, Brooks MM, et al. The effect of previous coronary-artery bypass surgery on the prognosis of patients with diabetes who have acute myocardial infarction. Bypass Angioplasty Revascularization Investigation Investigators. N Engl J Med. 2000 Apr 6;342(14):989-97. +Also: Davis KB, Alderman EL, Kosinski AS, et al. Early mortality of acute myocardial infarction in patients with and without prior coronary revascularization surgery. A Coronary Artery Surgery Study Registry Study. Circulation. 1992 Jun;85(6):2100-9. +Also: Milojevic M, Head SJ, Parasca CA, et al. Causes of Death Following PCI Versus CABG in Complex CAD: 5-Year Follow-Up of SYNTAX. J Am Coll Cardiol. 2016 Jan 5;67(1):42-55 (CABG patients 10x less likely to die of MI than PCI patients).

      3 80. The Bypass Angioplasty Revascularization Investigation (BARI) Investigators. Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. N Engl J Med 1996; 335: 217–25.

      4 81. Abizaid A, Costa MA, Centemero M, et al. Arterial Revascularization Therapy Study Group. Clinical and economic impact of diabetes mellitus on percutaneous and surgical treatment of multivessel