What question did this study set out to answer?

The study investigates the efficacy and safety of prophylactic coronary revascularization in patients with extensive stress-induced ischemia prior to major vascular surgery.

June 13, 2026Journal of the American College of Cardiology

A Clinical Randomized Trial to Evaluate the Safety of a Noninvasive Approach in High-Risk Patients Undergoing Major Vascular Surgery

View Full Paper

Ask AI

Bookmark

Authors

DPDon PoldermansUniversità Cattolica del Sacro Cuore OSOlaf SchoutenIsala RVRadosav VidakovićUniversity of Belgrade

Discussion

Member takes

Key expert perspectives

Captured external expert commentary on this paper, strongest first. Original sources are linked where available.

DP Don PoldermansProfessor of cardiology, Erasmus MC Rotterdam

“While cardiac oxygen demand/supply mismatch in patients with coronary artery disease might be counteracted by appropriate beta-blocker use or coronary revascularisation in these patients, coronary plaque instability leading to plaque rupture and thrombosis remains a significant problem”

Erasmus MC RotterdamNews Coverage

Implication

Caution against routine prophylactic use before vascular surgery; leaves open need for larger efficacy trials.

Key Points

The study investigates the efficacy and safety of prophylactic coronary revascularization in patients with extensive stress-induced ischemia prior to major vascular surgery.
Screened 1880 high-risk patients for coronary artery disease based on risk factors.
Utilized dobutamine echocardiography or stress nuclear imaging for cardiac testing.
Randomly assigned 101 patients with extensive ischemia to receive or not receive revascularization.
Revascularization did not improve 30-day outcomes, with a composite endpoint incidence of 43% in the revascularization group vs. 33% in the control group (odds ratio 1.4, 95% CI 0.7 to 2.8; p=0.30).
No benefit observed during the 1-year follow-up, with composite endpoint incidence of 49% vs. 44% (odds ratio 1.2, 95% CI 0.7 to 2.3; p=0.48).
Two patients died due to ruptured aneurysm prior to surgery after revascularization.

Cite This Study

Poldermans et al. (2007) studied this question.

synapsesocial.com/papers/6a2ccc20b3cfc6b60e4443e5 https://doi.org/10.1016/j.jacc.2006.11.052

View Full Paper

Ask AI

Bookmark