The adjunctive treatment of patients who undergo incomplete revascularization is a real unmet need. The results from the RIVER-PCI trial showed that about 27% of patients who undergo an incomplete revascularization with percutaneous coronary intervention have a major ischemia-driven event within the next 2 years. In RIVER-PCI, we were unable to prevent these events by giving patients the anti-ischemia drug ranolazine.
In the study, the rates of new MIs and cardiovascular mortality were relatively low. It was recurrent ischemic events that drove the outcome we saw. If nothing else, this study has opened a new avenue for research into this high-risk group of patients.
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| Mitchel L. Zoler/Frontline Medical News Dr. Gregg W. Stone |
As interventional cardiologists, we don’t usually think about the coronary disease that we leave behind following a revascularization procedure. Patients who undergo incomplete revascularization may avoid having an excess of future MIs or death, but they still experience a lot of angina, which leads to rehospitalizations and new procedures. I think we could improve the quality of life for our patients if we can come up with new ways to improve revascularization procedures and better approaches to preventing ischemia and angina following these procedures.
Dr. Gregg W. Stone was chairman of the RIVER-PCI trial and is professor and director of cardiovascular research and education at the Center for Interventional Vascular Therapy at Columbia University in New York. He has been a consultant to nine companies but has no relationship with Gilead Sciences and the Menarini Group, the two companies that sponsored the trial and that market ranolazine. He made these comments during the session that discussed the RIVER-PCI results.
AT TCT 2015
