Re-evaluating revascularization

Michael Marber,
Department of Cardiology, Cardiovascular Division,
The Rayne Institute, St Thomas’ Hospital, London, UK
Heart Metab. (2013) 58:2–3

• This issue of Heart and Metabolism is dedicated to a core aspect of cardiology, revascularization. Although atherosclerosis is often viewed as a seemingly simple plumbing problem, this issue highlights the complexity of the underlying coronary physiology and the multiple pathways that can lead to myocardial ischemia. For patients with stable angina, these complexities act in concert to influence decisions regarding revascularization. To appreciate these complexities better, and to enjoy the content of this issue, it is best to read the articles in an order that differs from our stereotypical layout.
  The historic journey from early physiology to present day percutaneous and surgical revascularization is beautifully told in the Refresher Corner article by Spencer King. We are privileged to have the story explained by someone so intimately involved with the evolution of revascularization. This unusual Refresher Corner uses the history of revascularization as a backdrop to the dilemmas that now face cardiologists in interpreting the Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation (COURAGE), the Bypass Angioplasty Revascularization
  Investigation 2 Diabetes (BARI-2D) and the Fractional Flow Reserve versus Angiography for Multivessel Evaluation (FAME) trials. These trials, and their impact on contemporary practice, are a theme that echoes through all the articles in this issue. (…)