The value proposition in percutaneous coronary intervention.

New therapies are incorporated into clinical practice for a variety of reasons. Usually, they are more efficacious than what is currently used for a specific disease state. Sometimes, they are just as efficacious but safer. When a new treatment strategy is able to achieve better efficacy and safety, at an equal or lower cost, it becomes a “dominant” strategy. Few therapies in cardiovascular medicine are considered dominant because efficacy and safety are often at oddsdfor example, the use of potent antiplatelet therapies in the management of acute coronary syndrome (ACS) reduces the risk of recurrent myocardial infarction at the risk of increased major bleeding (1)d