The five-year rates of heart attack, stroke, or death from any cardiovascular cause were 26.5% in the revascularization group and 27.6% with medical therapy alone.
“We need to figure out how to better treat them, because fixing their coronary arteries doesn’t seem to be giving them the benefit we thought it would, or hoped it would,” said Dr. Everett. “For the time being, this is not a test that should be routinely used on stable patients.”
The researchers also looked at how troponin levels changed over time.
“Despite aggressive medical therapy for type 2 diabetes and stable ischemic heart disease, the median troponin T concentration increased over one year of follow-up, and no significant reductions in troponin T concentrations were observed in patients who underwent coronary revascularization,” the researchers said.
“If this type of patient has elevated troponin, I would be more aggressive in medical management, including statins, smoking cessation, and lifestyle changes,” said Dr. Zhao of Wake Forest. “I think the next step would be to ideally run a clinical trial and see if, in patients with elevated troponin levels, intensified medical management reduces the number of events as compared to standard therapy.