Will the COURAGE trial change practice? Unlikely. It’s the same idea as watchful waiting, patients generally like to have interventions done – despite the (lack of) evidence:

Listen, one of the arteries feeding your heart is clogged up with plaque. I know you’ve got a little bit of chest pain, but we’ve got good evidence that clearing out the artery and putting in a stent isn’t going to do you much good over the long haul. So I’m just going to write you a few prescriptions and send you home. Okay? Have a nice day.

Despite the recent results of Courage, a large trial showing the limits of stents, that’s not a very likely conversation between cardiologists and their patients, according to doctors on a conference call we listened to this morning.