Harlan Krumholz Profile picture
Harold H. Hines Jr Professor, Yale Univ; Director, YNHH CORE; Editor-in-Chief, JACC. Working to improve the future for those who follow us...

Nov 17, 2019, 5 tweets

So #ISCHEMIA #AHA19 will take time to digest; lots presented and no peer-review pub or @medrxivpreprint yet. There is often drift from the big presentation to the publication. We should resist a rush to judgment. Yet…

@medrxivpreprint A couple of things occur to me from the presentations…reinforces the prior evidence that patients w/stable ischemic heart disease have little to lose by deferring procedures. The medical therapy strategy seems safe. The procedural strategy is not saving lives or events, to date.

@medrxivpreprint It seems to question value of myocardial perfusion imaging in patients w/stable ischemic heart disease. In aggregate large costs…and not clear, in many cases, what it is adding if the procedures are not saving lives or events. Combine that w/STICH, and the question gets bigger.

@medrxivpreprint The quality of life benefit in #ISCHEMIA will likely be debated for some time. @jspertus gave an impassioned defense of the finding, but many will be concerned about it in an open label study. Not clear that they will have the data to clarify this. #ORBITA is key here. #AHA19

@medrxivpreprint @jspertus But we need time to reflect on the findings - & the ability to really review everything. Team #ISCHEMIA, why not post #preprint on @medrxivpreprint and let us read your studies while you prepare for peer review. You have already presented. Community can give you comments. #AHA19

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