Document Detail


Diagnostic coronary angiography in patients with peripheral arterial disease: a sub-study of the Coronary Artery Revascularization Prophylaxis Trial.
MedLine Citation:
PMID:  18761563     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Although patients in need of elective vascular surgery are often considered candidates for diagnostic coronary angiography, the safety of this invasive study has not been systematically studied in a large cohort of patients scheduled for an elective vascular operation. The goal of this sub-study of the Coronary Artery Revascularization Prophylaxis (CARP) trial was to assess the safety of coronary angiography in patients with peripheral vascular disease. METHODS: The CARP trial tested the long-term benefit of coronary artery revascularization prior to elective vascular operations. Among those patients who underwent diagnostic coronary angiography during screening for the trial, the associated complications were determined at 24 hours following the diagnostic procedure. RESULTS: Over 5,000 patients were screened during a 4-year recruitment period at 18 major VA medical centers and the present cohort consists of 1,298 patients who underwent preoperative coronary angiography. Surgical indications for vascular surgery included an expanding aortic aneurysm (AAA) (n = 446; 34.4%) or arterial occlusive disease with either claudication (n = 457; 35.2%) or rest pain (n = 395; 30.4%). A total of 39 patients had a confirmed complication with a major complication identified in 17 patients (1.3%). Complication rates were higher in patients with arterial occlusive symptoms compared with expanding aneurysms (1.8% vs. 0.5%; P = 0.07) and were not dissimilar with femoral (2.8%) versus nonfemoral (4.7%) access sites (P = 0.42). CONCLUSIONS: Coronary angiography is safe in patients with peripheral arterial disease undergoing preoperative coronary angiography. The complication rate is higher in patients with symptoms of arterial occlusive disease.
Authors:
Santiago Garcia; Edward O McFalls; Steven Goldman; Greg C Larsen; Fred Littooy; Thomas E Moritz; Domenic J Reda; Herbert B Ward; Kendrick Shunk; Brack Hattler
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Publication Detail:
Type:  Evaluation Studies; Journal Article; Multicenter Study; Research Support, U.S. Gov't, Non-P.H.S.     Date:  2008-08-26
Journal Detail:
Title:  Journal of interventional cardiology     Volume:  21     ISSN:  1540-8183     ISO Abbreviation:  J Interv Cardiol     Publication Date:  2008 Oct 
Date Detail:
Created Date:  2008-11-17     Completed Date:  2009-03-04     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8907826     Medline TA:  J Interv Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  369-74     Citation Subset:  IM    
Affiliation:
Minneapolis Veterans Affairs Medical Center and the University of Minnesota, Minneapolis, MN 55417, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Arterial Occlusive Diseases / complications*,  diagnosis*,  surgery
Cohort Studies
Coronary Angiography / adverse effects*
Female
Hospitals, Veterans
Humans
Male
Middle Aged
Myocardial Revascularization
Outcome and Process Assessment (Health Care)
Peripheral Vascular Diseases / complications*,  diagnosis*,  surgery
Preoperative Care
Randomized Controlled Trials as Topic
Surgical Procedures, Elective
Treatment Outcome

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


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