Interventional Cardiology going downhill?

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HMSBeagle

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Hi everyone. I was wondering what is the current state of interventional cardiology. What got me thinking about this is the advent of CT and MR angiography. Some say this may be the beginning of the end for diagnostic coronary angiographies. Also, the reports of stents and how supposedly they may not be very effective, got me thinking about what the state of IC may be and what the future brings for this specialty.
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All fields of cardiology (or all of medicine, for that matter) are in a constant state of flux, so it's hard to predict.

For example, here are the two most common arguments regarding the future of interventional vs cardiac imaging.

1. Cardiac imaging will supplant diagnostic caths as imaging technology improves.

2. The increased utilization of imaging procedures will lead to a greater number of referrals to the cath lab, and thus, a greater number of procedures

No one knows what will happen in the future, but my guess is that interventional is far from going downhill. There are too many new exciting technologies (novel stent technologies, percutaneous bypass, percutaneous deployment of angiogensis-promoting devices, Percutanous valve repair, etc).

There is a great deal of hype when any new technology is introduced. After the technology has been used, much of the hype dissipates and disappointment pervades the general mood. As the technology matures; however, its role becomes more defined.

So, while cardiac CT, MRI, 3d US are definitely the next big thing in cardiology, it will most likely be complementary to the other fields of cardiology.
 
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Cardiac CT/MRI will have little if any impact in interventional cards.

They have zero therapeutic value - only diagnostic.
 
All of the following were taken from www.theheart.org . Please go there for additional info:



No increased death, MI with DES in randomized trials and registries, "mega"-meta-analysis suggests
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Mortality reduced at two years in AMI patients treated with DES: Massachusetts registry
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Stents equivalent to surgery in left main disease
Mar 31, 2008 14:45 EDT / New registry data from Korea indicate that stenting the left main coronary artery is as safe as performing bypass surgery. The results were hailed as impressive, but most observers say it will be necessary to wait for the results of SYNTAX—an ongoing randomized trial in the US—before changing practice. (Seung KB et al. New Engl J Med; published online before print March 31, 2008. American College of Cardiology 2008 Scientific Sessions.)

Off-site PCI comparable to PCI with on-site backup
Apr 2, 2008 16:00 EDT / UPDATED WITH VIDEO INTERVIEW // The largest-ever clinical analysis and comparison of PCI centers with and without surgical backup in the US has shown that PCI facilities without on-site surgery have similar outcomes to centers with traditional backup. (American College of Cardiology 2008 Scientific Sessions.)

Percutaneous valve clip reduces mitral regurgitation and reverse remodeling in functional MR patients
Apr 1, 2008 16:00 EDT / Over 12 months, the percutaneous procedure that emulates edge-to-edge mitral-valve repair appears to reduce mitral regurgitation and improve LV dimentions/function in patients with functional MR successfully treated with the device. (American College of Cardiology 2008 Scientific Sessions)
 
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