{"id":225,"date":"2007-05-13T20:24:00","date_gmt":"2007-05-13T19:24:00","guid":{"rendered":"http:\/\/resource.bmj.com\/bmj\/2007\/05\/13\/jama-9-may-2007-vol-297\/"},"modified":"2007-05-13T20:24:00","modified_gmt":"2007-05-13T19:24:00","slug":"jama-9-may-2007-vol-297","status":"publish","type":"post","link":"https:\/\/blogs.bmj.com\/bmj\/2007\/05\/13\/jama-9-may-2007-vol-297\/","title":{"rendered":"JAMA 9 May 2007  Vol 297"},"content":{"rendered":"<p>After myocardial infarction, areas of the myocardium may remain ischaemic without producing any symptoms \u2013 this is known as silent ischaemia and is revealed by sophisticated forms of stress imaging. Between 1991 and 1997, well before it became clear that all patients with MI do better with immediate percutaneous intervention (PCI), a group of Swiss hospital randomised their heart attack patients with silent ischaemia to drug treatment or PCI after investigation.<!--more-->The patients who received PCI did better. <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/abstract\/297\/18\/1985\">This SWISSI-II trial<\/a> should be historical footnote, but given that the UK can only manage a 25% rate of immediate PCI at the time of MI, it may be of some relevance here even now.<\/p>\n<p>Nothing in interventional cardiology stays the same for long. Until a few months ago, we all thought that <a href=\"http:\/\/jama.ama-assn.org\/cgi\/content\/abstract\/297\/18\/1992\">drug-eluting stents<\/a> were obviously better than bare-metal stents and doctors began to use them for patients who did not fulfil the trial criteria \u2013 so called \u201coff-label<\/p>\n","protected":false},"excerpt":{"rendered":"<p>After myocardial infarction, areas of the myocardium may remain ischaemic without producing any symptoms \u2013 this is known as silent ischaemia and is revealed by sophisticated forms of stress imaging. [&#8230;]<\/p>\n<p><a class=\"btn btn-secondary understrap-read-more-link\" href=\"https:\/\/blogs.bmj.com\/bmj\/2007\/05\/13\/jama-9-may-2007-vol-297\/\">More&#8230;<\/a><\/p>\n","protected":false},"author":1,"featured_media":38363,"comment_status":"open","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"footnotes":""},"categories":[111],"tags":[],"class_list":["post-225","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-richard-lehmans-weekly-review-of-medical-journals"],"yoast_head":"<!-- This site is optimized with the Yoast SEO plugin v27.4 - https:\/\/yoast.com\/product\/yoast-seo-wordpress\/ -->\n<title>JAMA 9 May 2007 Vol 297 - The BMJ<\/title>\n<meta name=\"robots\" content=\"index, follow, max-snippet:-1, max-image-preview:large, max-video-preview:-1\" \/>\n<link rel=\"canonical\" href=\"https:\/\/blogs.bmj.com\/bmj\/2007\/05\/13\/jama-9-may-2007-vol-297\/\" \/>\n<meta property=\"og:locale\" content=\"en_US\" \/>\n<meta property=\"og:type\" content=\"article\" \/>\n<meta property=\"og:title\" content=\"JAMA 9 May 2007 Vol 297 - The BMJ\" \/>\n<meta property=\"og:description\" content=\"After myocardial infarction, areas of the myocardium may remain ischaemic without producing any symptoms \u2013 this is known as silent ischaemia and is revealed by sophisticated forms of stress imaging. 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