This Article  • Full text  • PDF  • Send to a friend  • Save in My Folder  • Save to citation manager  • Permissions  Citing Articles  • Citation map  • Citing articles on HighWire  • Contact me when this article is cited  Related Content  • Related article  • Similar articles in JAMA  Topic Collections  • Revascularization  • Cardiovascular System  • Quality of Care  • Evidence-Based Medicine  • Quality of Care, Other  • Surgery  • Surgical Interventions  • Cardiovascular/ Cardiothoracic Surgery  • Cardiovascular Disease/ Myocardial Infarction  • Cardiovascular Intervention  • Alert me on articles by topic  Social Bookmarking   What's this?

George A. Diamond, MD; Sanjay Kaul, MD

JAMA. 2008;300(15):1817-1819.

	Since this article does not have an abstract, we have provided the first 150 words of the full text and any section headings.

Despite increasing evidence supporting plaque instability as the proximate cause of atherosclerotic events,^1-2 treatment strategies continue to focus on the anatomic stenosis.³ This preoccupation with coronary luminology causes clinicians to perform stress tests and angiograms to identify flow-limiting lesions, even among asymptomatic patients, and to mitigate the effects of these lesions by direct mechanical or surgical intervention. As a result, clinical practice guidelines currently recommend revascularization when stress testing reveals demonstrable myocardial ischemia despite optimal medical management.^3-4

Unfortunately, the guidelines are not as clear as they might be on this matter. For example, one guideline reads as follows³:

[Percutaneous coronary intervention] may be considered in patients with [Canadian Cardiovascular Society] class III angina and no evidence of ischemia on noninvasive testing or who are undergoing medical therapy and have 2- or 3-vessel [coronary artery disease] with significant proximal [left anterior descending coronary . . . [Full Text of this Article]

CiteULike    Connotea    Del.icio.us    Digg    Reddit    Technorati    Twitter     What's this?

RELATED ARTICLE

Frequency of Stress Testing to Document Ischemia Prior to Elective Percutaneous Coronary Intervention
Grace A. Lin, R. Adams Dudley, F. L. Lucas, David J. Malenka, Eric Vittinghoff, and Rita F. Redberg
JAMA. 2008;300(15):1765-1773.
ABSTRACT | FULL TEXT  

THIS ARTICLE HAS BEEN CITED BY OTHER ARTICLES

Stress Testing Prior to Percutaneous Coronary Intervention
JWatch General 2008;2008:2-2.
FULL TEXT  

Stress Testing Before Elective Percutaneous Coronary Intervention
Journal Watch Cardiology 2008;2008:2-2.
FULL TEXT