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  • Long term follow up after deferral of revascularisation in patients with intermediate coronary stenoses and negative dobutamine stress echocardiography

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Long term follow up after deferral of revascularisation in patients with intermediate coronary stenoses and negative dobutamine stress echocardiography
  1. T Giesler,
  2. S Lamprecht,
  3. J-U Voigt,
  4. D Ropers,
  5. K Pohle,
  6. J Ludwig,
  7. F A Flachskampf,
  8. W G Daniel,
  9. U Nixdorff
  1. Department of Internal Medicine II, University of Erlangen-Nuremberg, Germany
  1. Correspondence to:
    Dr Tom Giesler, Medizinische Klinik II mit Poliklinik der Universität Erlangen-Nuremberg, D-91054 Erlangen, Ulmenweg 18, Germany;
    tom.giesler{at}rzmail.uni-erlangen.de

https://doi.org/10.1136/heart.88.6.645

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    Quantitative coronary angiography (QCA) provides anatomic data of a coronary stenosis, but not necessarily information about the physiologic relevance of a lesion. It is unclear, however, whether patients with intermediate coronary stenoses (≥ 50% to ≤ 70% diameter reduction) show a long term benefit after coronary intervention.1 Also, for patients with intermediate stenoses, only few data on the risk for future coronary events are available.2

    The objective of this pilot study was to determine the safety and outcome of performing or deferring coronary interventions in patients with intermediate stenoses based on the results of dobutamine stress echocardiography (DSE).

    METHODS

    Patients with one intermediate stenosis by QCA (diameter stenosis ≥ 50% and ≤ 70%) in one of the main coronary arteries or in a coronary artery bypass graft and eligible for revascularisation were included in the study. A total of 47 consecutive patients (34 men, 13 women) referred for coronary angiography was examined (mean (SD) age 61.2 (10.2) years, weight 76.5 (11.7) kg, left ventricular ejection fraction 65.4 (11.6)%).

    DSE was performed within two days after coronary angiography. In patients with inducible myocardial ischaemia by DSE in the perfusion territory of the target vessel, coronary intervention was performed (Int group), while in patients with negative DSE the intervention was deferred (non-Int group). …

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