Long-term outcomes of optimized medical management of outpatients with stable XXXX .

@entity1 @entity1109 @entity1459 @entity951 @entity453 @entity583 @entity204
The objective of this study was to assess long-term clinical outcomes and their correlates in medically managed outpatients with stable @entity951 , healed @entity583 ( @entity583 ), or documented asymptomatic @entity453 ( @entity453 ). Management strategy emphasized maximally tolerated medical therapy and modification of coronary risk factors. Referral to invasive coronary interventions followed stricter criteria than standard published guidelines. Primary study outcomes were all-cause mortality or nonfatal @entity583 . Secondary study outcomes included @entity204 , @entity1459 , or coronary revascularization. A total of 693 @entity1 and @entity1 with proved @entity453 (mean age 67 years at entry, 85% @entity1 , 41% with history of @entity583 ) were enrolled. The annual incidence of nonfatal @entity583 , cardiac mortality, and total mortality was 2.2%, 0.8%, and 1.4%, respectively, during an average follow-up of 4.6 years. Coronary revascularization was performed in 24% of subjects; unstable or progressive @entity1109 were the most common reasons for revascularization. In @entity1 with documented stable @entity453 , a management strategy based on intensive medical therapy and modification of established coronary risk factors was associated with excellent long-term outcomes. Thus, coronary interventions can be safely delayed until clinical instability ensues, without increased risk of @entity583 or @entity204 . This treatment approach represents a viable alternative to invasive strategies.
