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Angiography Before Vascular Surgery May Be Beneficial

Systematic coronary angiography in certain patients linked to improved long-term outcomes

THURSDAY, Sept. 3 (HealthDay News) -- Routine coronary angiography may improve long-term outcomes in certain patients undergoing surgery for peripheral arterial disease, according to research published in the Sept. 8 issue of the Journal of the American College of Cardiology.

Mario Monaco, M.D., of the Istituto Clinico Pineta Grande in Castelvolturno, Italy, and colleagues analyzed data from 208 patients who were scheduled for elective surgery for major vascular disease. Patients had a revised cardiac risk index of two or greater and were randomized to a group that received coronary angiography based on noninvasive tests, or to a group in which patients systematically had preoperative coronary angiography. Patients were followed for at least three years for major adverse cardiovascular events.

The researchers found that the latter group had a higher myocardial revascularization rate (58.1 versus 40.1 percent). This group also had better survival at 58 months of follow-up and freedom from death/cardiovascular events, but did not have a significantly lower rate of in-hospital major adverse cardiovascular events.

"Patients at medium-high risk of cardiovascular events scheduled to undergo major vascular surgery, and in whom coronary angiography was systematically performed as part of their preoperative workup, scored significantly better than patients in whom coronary angiography was selectively performed only on the basis of positive noninvasive tests. Our data indicate that the advantages of such a systematic approach may significantly offset its disadvantages," the authors write.

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