Indications for revascularization in stable angina?

[Chloroform4Life]

I've been googling for the answer to this and its still not very clear to me. What are the indications for stents/CABG in a patient without ACS? Significant LAD stenosis? Significant multi-vessel disease? Concurrent low EF?

I assume these are the patients we are trying to identify with pre-op stress testing where they actually need revascularization before their noncardiac surgery.

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[deleted171991]

http://www.uptodate.com/contents/stable-ischemic-heart-disease-indications-for-revascularization?source=search_result&search=Stable+angina+revascularization&selectedTitle=2~150&view=outline

http://www.uptodate.com/contents/search.do?search=Stable+angina+revascularization&submitType=Search

 

[GravelRider]

In low to moderate risk patients, PCI helps to improve symptoms, but no benefit in survival versus medical therapy. In higher risk patients, PCI improves survival. The question then becomes who is low risk versus who is high risk. Left main disease, multiple coronaries involved, reduction in EF, and symptoms all guide the decision on whether to revascularize. Nuclear studies can give you an idea of the area of ischemia...or myocardium at risk.

 

[Chloroform4Life]

http://www.uptodate.com/contents/stable-ischemic-heart-disease-indications-for-revascularization?source=search_result&search=Stable+angina+revascularization&selectedTitle=2~150&view=outline

http://www.uptodate.com/contents/search.do?search=Stable+angina+revascularization&submitType=Search

I found those up to date links too, but I dont have a subscription so I couldn't read them.

 

[deleted171991]

I found those up to date links too, but I dont have a subscription so I couldn't read them.

Oh, sorry. I am on my iPad mini and having trouble copy-pasting the relevant info from there.

 

[itwasalladream]

Appendix 3 (the last 2 pages of this PDF) might answer your question. It refers to revascularization guidelines put out in 2011