Diagnostic value of exercise electrocardiography and angina after coronary artery stenting

Legrand, Victor; Raskinet, B; Laarman, Gert Jan; Danchin, Nicolás; Morel, Marie Angèle; Serruys, Patrick W.

doi:10.1016/s0002-8703(97)70214-x

Cited by 18 publications

(10 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…22,23 This is consistent with our finding that men were more likely than women to have restenosis without symptoms, because the women in this study had smallercaliber arteries than men, no difference in percent diameter stenosis, and a trend toward a smaller MLD.…”

Section: Discussionsupporting

confidence: 90%

Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

et al. 2001

Self Cite

View full text Add to dashboard Cite

Background Angiographic restenosis after percutaneous coronary interventional procedures is more common than recurrent angina. Clinical and angiographic factors associated with asymptomatic versus symptomatic restenosis after percutaneous coronary intervention were compared. Methods and Results All patients with angiographic restenosis from the BENESTENT I, BENESTENT II pilot, BENESTENT II, MUSIC, WEST 1, DUET, FINESS 2, FLARE, SOPHOS, and ROSE studies were analyzed. Multivariate analysis evaluated 46 clinical and angiographic variables, comparing those with and without angina. The 10 studies recruited 2690 patients who underwent percutaneous revascularization and 6-month follow-up angiography (86% of those eligible). Restenosis (≥50% diameter stenosis) occurred in 607 patients and was clinically silent in 335 (55%). Male sex ( P =0.008), absence of antianginal therapy with nitrates ( P =0.0002) and calcium channel blockers ( P =0.02) at 6 months, greater reference diameter after the procedure ( P =0.04), greater reference diameter at follow-up ( P =0.004), and lesser lesion severity (percent stenosis) at 6 months ( P =0.0004) were univariate predictors of asymptomatic restenosis. By multivariate analysis, only male sex ( P =0.04), greater reference diameter at follow-up ( P =0.002), and lesser lesion severity at 6 months ( P =0.0001) were associated with restenosis without angina. Conclusions Approximately half of patients with angiographic restenosis have no symptoms. The only multivariate predictors of silent restenosis at 6 months were male sex, greater reference diameter at follow-up, and lesser lesion severity on follow-up angiography.

show abstract

Section: Discussionsupporting

confidence: 90%

Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

et al. 2001

Self Cite

View full text Add to dashboard Cite

show abstract

“…Although coronary stent implantation is unlikely to affect the accuracy of exercise-induced ischemia at follow-up for the detection of restenosis [11], the lowered rates of restenosis will adversely affect the cost-efficacy of a routine testing strategy. In contrast, multivessel PTCA is increasingly being performed.…”

Section: Discussionmentioning

confidence: 99%

Cost-efficacy modeling of functional testing with perfusion imaging to detect asymptomatic restenosis following percutaneous transluminal coronary angioplasty

Mak

Eisenberg

Shaw

1999

Cathet. Cardiovasc. Intervent.

View full text Add to dashboard Cite

“…Others (35)(36)(37) observed no such correlation. Minimal lumen diameter rather than stenosis severity may be more predictive of angina (34). Some have found that neither angina status before PCI (22,37,38) nor diabetes mellitus (16,22,34,37,38) is correlated with symptomatic status.…”

Section: Abbreviations and Acronymsmentioning

confidence: 99%

“…Exercise ECG has repeatedly been demonstrated to be inaccurate in detecting restenosis following revascularization (13,15,16,34,36,37,54). In contrast, the sensitivity and specificity of MPI, performed at varying times after PCI, range from 39% to 100% and 46% to 100%, respectively (15,26,37,45,54 -59), improving with time since revascularization (Table 4).…”

Section: Use Of Noninvasive Testingmentioning

confidence: 99%

Myocardial perfusion imaging following percutaneous coronary intervention

Giedd

Bergmann

2004

Journal of the American College of Cardiology

View full text Add to dashboard Cite

Percutaneous coronary intervention (PCI) has become a mainstay in the treatment of patients with coronary artery disease. Currently, more than one million coronary angioplasty and stent implantation procedures are performed annually. Although increasingly complex lesions and higher risk patients are being successfully treated percutaneously, restenosis and disease progression continue to cause significant morbidity. Restenosis occurs in approximately one-third of patients, one-half of who remain asymptomatic, while disease progression occurs at rates approaching 7% per year. Despite technological advances, unadjusted mortality rates have actually increased since the mid-1980s, and the current annual risk of a major adverse cardiac event following PCI is 5% to 7%. Although randomized clinical trials are needed to more definitively show a benefit, when performed six or more months following PCI, myocardial perfusion imaging reliably identifies patients most at risk of a poor long-term outcome. Directed reintervention can have a salutary impact on the prognosis of these patients. In view of recent data showing a positive impact of imaging and reintervention in patients after PCI, current guidelines should be reassessed.

show abstract

Diagnostic value of exercise electrocardiography and angina after coronary artery stenting

Cited by 18 publications

References 29 publications

Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

Clinical and Angiographic Factors Associated With Asymptomatic Restenosis After Percutaneous Coronary Intervention

Cost-efficacy modeling of functional testing with perfusion imaging to detect asymptomatic restenosis following percutaneous transluminal coronary angioplasty

Myocardial perfusion imaging following percutaneous coronary intervention

Contact Info

Product

Resources

About