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dc.contributor.authorAndersen, K
dc.contributor.authorSteinthorsdottir S. D
dc.contributor.authorHaraldsdottir S
dc.contributor.authorGudnason, T
dc.date.accessioned2010-01-11T11:20:43Z
dc.date.available2010-01-11T11:20:43Z
dc.date.issued2009-12-01
dc.date.submitted2010-01-11
dc.identifier.citationScand Cardiovasc J. 2009, 43(6):402-7en
dc.identifier.issn14017431
dc.identifier.issn16512006
dc.identifier.pmid19412835
dc.identifier.doi10.1080/14017430902926873
dc.identifier.urihttp://hdl.handle.net/2336/89093
dc.descriptionTo access publisher full text version of this article. Please click on the hyperlink in Additional Links fielden
dc.description.abstractObjectives. 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.
dc.language.isoenen
dc.publisherInforma Healthcareen
dc.relation.urlhttp://dx.doi.org/10.1080/14017430902926873en
dc.subject.meshPubMed in Processen
dc.titleClinical evaluation and stress test have limited value in the diagnosis of in-stent restenosisen
dc.typeArticleen
dc.contributor.departmentUniversity of Iceland, Faculty of Medicine, Reykjavik, IS 101, Iceland. andersen@landspitali.isen
dc.identifier.journalScandinavian Cardiovascular Journalen
html.description.abstractObjectives. 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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