| Clinical evaluation and stress test have limited value in the diagnosis of in-stent restenosis. | |
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MedLine Citation:
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PMID: 19412835 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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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. |
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Authors:
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Karl Andersen; Sandra D?s Steinth?rsd?ttir; Sigurdis Haraldsdottir; Thorarinn Gudnason |
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Publication Detail:
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Type: Clinical Trial; Journal Article |
Journal Detail:
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Title: Scandinavian cardiovascular journal : SCJ Volume: 43 ISSN: 1651-2006 ISO Abbreviation: Scand. Cardiovasc. J. Publication Date: 2009 Dec |
Date Detail:
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Created Date: 2009-12-09 Completed Date: 2010-02-22 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 9708377 Medline TA: Scand Cardiovasc J Country: England |
Other Details:
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Languages: eng Pagination: 402-7 Citation Subset: IM |
Affiliation:
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University of Iceland, Faculty of Medicine, Reykjavik, IS 101, Iceland. andersen@landspitali.is |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aged Coronary Angiography Coronary Restenosis / diagnosis* Electrocardiography Exercise Test* Female Humans Male Middle Aged Predictive Value of Tests Prospective Studies Questionnaires |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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