Document Detail

Clinical evaluation and stress test have limited value in the diagnosis of in-stent restenosis.
MedLine Citation:
PMID:  19412835     Owner:  NLM     Status:  MEDLINE    
OBJECTIVES: In-stent restenosis (ISR) is the main limitation of percutaneous coronary interventions (PCI), occurring in approximately 25% of cases. Although frequently asymptomatic, many PCI patients present with recurrent symptoms of chest pain at follow-up raising a clinical suspicion of ISR. The diagnosis of ISR can be challenging in these patients and difficult to rule out without repeat coronary angiography. DESIGN: We prospectively investigated the diagnostic accuracy of clinical evaluation and exercise stress testing to detect ISR as compared to coronary angiography, in a consecutive, unselected cohort of PCI patients. RESULTS: We studied 91 patients with a total of 143 stents. Clinical evaluation predicted ISR to be likely in 19% of cases and the exercise test was positive in 29%. The binary restenosis rate was 21%. Clinical evaluation had a positive predictive value of 29% and accuracy of 71%, while exercise stress testing had a positive predictive value of 19% and accuracy of 65%. CONCLUSION: In conclusion, we found the diagnostic accuracy of clinical evaluation to be low and not significantly improved by exercise stress testing when evaluating PCI patients for ISR.
Karl Andersen; Sandra D?s Steinth?rsd?ttir; Sigurdis Haraldsdottir; Thorarinn Gudnason
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Publication Detail:
Type:  Clinical Trial; Journal Article    
Journal Detail:
Title:  Scandinavian cardiovascular journal : SCJ     Volume:  43     ISSN:  1651-2006     ISO Abbreviation:  Scand. Cardiovasc. J.     Publication Date:  2009 Dec 
Date Detail:
Created Date:  2009-12-09     Completed Date:  2010-02-22     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9708377     Medline TA:  Scand Cardiovasc J     Country:  England    
Other Details:
Languages:  eng     Pagination:  402-7     Citation Subset:  IM    
University of Iceland, Faculty of Medicine, Reykjavik, IS 101, Iceland.
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MeSH Terms
Coronary Angiography
Coronary Restenosis / diagnosis*
Exercise Test*
Middle Aged
Predictive Value of Tests
Prospective Studies

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine

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