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Posts Tagged ‘BARI 2D’

CAD management has been riddled with controversy for over decades. Should we  revascularise  all  obstructive CAD  we encounter ? Logic and scientific presumptions argued a strong case for it , and hence most of these patient population got some form  of revascularisation .(PCI or CABG ) .

This continued for years  till COURAGE study threw a shocker !  ie  medical management is as good as any from revascularisation in stable angina patients. While , the cardiology community was divided over the COURAGE conclusion ,  here comes another shocker  from the New England journal of medicine  ( June 2009 ) ,  against  revascularisation  The BARI 2D  trial . It shattered  the ultimate  myth,    in  diabetic  CAD patients  , neither PCI nor CABG  has  survival advantage among   diabetic population .

bari 2d  pci coronary

The art of  unlearning  cardiology:

The beauty of  evidence based medicine (EBM )  is  ,  genuine science  will ultimately   prevail  over  pseudo science. But  the danger with  EBM  is  , it   conquers the  truth  in it’s own time frame .In the process ,  EBM has to overcome so many hurdles , both natural , man made,  advertent or  inadvertent but ultimately truth must triumph  , at least we hope it triumphs . In the intervening time ,  it   has become   absolutely essential ,   for the   humans  to  suffer . The only way ,  mankind ,  can be protected  from  this deadly game of EBM  is that ,  our physicians  should have  the  inherent  fore- sight to identify &  ignore the “Would be doomed evidence” !

There are many such physicians  in this world . . . who  ignore  some of the  standard  scientific  guidelines  for the betterment of their patients

Reference

1.NEJM article June 11 20o9

2.Journal watch cardiology

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