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Editorial
Less Is More
May 2016

Continuing Use of Prophylactic Percutaneous Coronary Intervention in Patients With Stable Coronary Artery Disease Despite Evidence of No BenefitDéjà Vu All Over Again

Author Affiliations
  • 1Department of Cardiovascular Medicine, Washington University School of Medicine, St Louis, Missouri
  • 2Department of Medicine, University of California, San Francisco, San Francisco
  • 3Editor, JAMA Internal Medicine
JAMA Intern Med. 2016;176(5):597-598. doi:10.1001/jamainternmed.2016.0600

More than 50 million surgical procedures are performed annually in the United States1 and it has been estimated that nearly 1 million adverse cardiac events occur each year following noncardiac operations.2 In fact, cardiovascular complications are the leading cause of death within 30 days of noncardiac surgery.3 Multiple factors unique to the postoperative environment, such as sympathetic stimulation, hypercoagulable state, inflammation, hypotension, hypothermia, and tachycardia, are thought to contribute to occurrence of adverse cardiac events.3 Approximately half of patients who experience a perioperative myocardial infarction (MI) have evidence of plaque rupture (type 1 MI) with the remainder related to ischemia from supply/demand mismatch (type 2 MI).4

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