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Invited Commentary
October 2014

Fighting the “Oculostenotic Reflex”

Author Affiliations
  • 1Division of General Internal Medicine, University of California, San Francisco
  • 2Philip R. Lee Institute for Health Policy Studies, University of California, San Francisco
JAMA Intern Med. 2014;174(10):1621-1622. doi:10.1001/jamainternmed.2014.164

In recent years, there has been intense focus in the scientific community and media on the potential overuse of percutaneous coronary interventions (PCI) in patients with stable angina. Although PCI has proven to be effective in decreasing mortality rates among patients with acute myocardial infarction, it has not been shown to prevent cardiovascular events for patients with stable angina. It may, however, have a small effect on symptom relief in the short term when added to optimal medical therapy. Because of this small effect size and its short duration, researchers have concluded that PCI is not cost effective for treating patients with stable angina.1 About 30% of PCIs performed in the United States each year are to treat patients with stable angina.