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Sunday, September 13, 2009

NEJM -- Coronary-Artery Revascularization before Elective Major Vascular Surgery

NEJM -- Coronary-Artery Revascularization before Elective Major Vascular Surgery: "Conclusions Coronary-artery revascularization before elective vascular surgery does not significantly alter the long-term outcome. On the basis of these data, a strategy of coronary-artery revascularization before elective vascular surgery among patients with stable cardiac symptoms cannot be recommended."

In a study in 510 pts with CAD (at least one vessel with 70% stenosis or worse, amenable to PTCA or CABG; all with LVEF 20% or better) undergoing major elective vascular surgery randomized to coronary revascularization or to medical therapy alone, after median 2.7y f/u, there was no sig. diff. in overall mortality or 30d incidence of (MI or death)