Ischemia’ in the absence of clinical symptoms under the guise of being ‘compulsive/thorough.’

Health (Temple, TX) told TCTMD in an email that the study supportsĬurrent practice guidelines and appropriate use criteria.ĭocs are still ordering ‘routine follow-up imaging studies to assess for Suggests that the presence and severity of myocardial ischemia are importantĬorrelates of prognosis in stable CAD and possibly of the benefit of Of treating ischemia because our patients were treated, and clear evidence They add, “our findings should not be interpreted as detracting from the value Ischemia “ the importance of implementing optimal medical therapyĪnd preventive measures regardless of symptoms or ischemia,” Dr. When angina was examined by severity, the risk ofĬardiovascular death or nonfatal MI was higher among patients with CanadianĬardiovascular Society class I symptoms (HR 1.85 95% CI 1.36-2.53), class II symptoms (HR 1.47 ĩ5% CI 1.11-1.95), and class III or IV symptoms (HR 1.76 95% CI 1.15-2.69)įact that most of the events occurred in patients free from both angina and Outcomes, and they were consistent across several sensitivity analyses. When looking at cardiovascular death and fatal or nonfatal MI as individual 2-Year Risk of Cardiovascular Death or MI Sex, geographic region, smoking status, hypertension, diabetes, and Ischemia-but not among those with silent ischemia-after adjustment for age, Nonfatal MI among patients with angina alone and those with both angina and Symptoms or ischemia, there was an elevated risk of cardiovascular death or Neither angina nor ischemia another 12.4% were associated with ischemia alone,ġ2.2% with angina alone, and 17.3% with both. Myocardial ischemia without angina (silent ischemia, 14.9%)ĭeaths or nonfatal MIs during follow-up.They were divided into 4 groups, with angina determined by physician evaluation: The new analysis included 20,291 patients who had undergone noninvasive testing for myocardial ischemia in the year before enrollment. CABG or PCI more than 3 months before enrollment.Chest pain with evidence of MI on a stress electrocardiogram.

Angiographic evidence of coronary stenosis > 50%.

Documented MI more than 3 months before enrollment.

Gabriel Steg, MD, of Hôpital Bichat (Paris, France), and colleagues looked atĭata from the prospective CLARIFY registry, which enrolled patients from 45Ĭountries (not including the United States) from November 2009 to June 2010 andįollowed them for a median of 2 years.

Class iii angina