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David E. Wennberg, MD, MPH; Merle A. Kellett, Jr, MD; John D. Dickens, Jr; Leonard M. Keilson, MD, MPH
Maine Medical Center Portland

David J. Malenka, MD
Dartmouth-Hitchcock Medical Center Lebanon, NH

Robert B. Keller, MD
Maine Medical Assessment Foundation Augusta

JAMA. 1996;276(7):529.

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

In Reply.

—Whether patients with known or suspected noncardiac vascular disease should have evaluation for coronary artery disease is an important clinical question. Patients with peripheral vascular disease are at a high risk for fatal and nonfatal cardiac events.¹ While significant work has been done concerning the preoperative cardiac evaluation in patients undergoing noncardiac vascular surgery,² debate continues about how to manage these patients even after the extent of their disease is known.³ Finally, there is no consensus about whether case finding and risk stratification is either appropriate or costeffective in the population being evaluated in a vascular laboratory. Thus, the question of the use of exercise testing raised by Dr Crouse and colleagues is relevant. Unfortunately, our data could not allow us to discern between those undergoing testing for symptoms and those undergoing testing for case finding and stratification.

However, the use of exercise testing in the setting . . . [Full Text PDF of this Article]

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