{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,9,12]],"date-time":"2025-09-12T17:47:04Z","timestamp":1757699224894},"reference-count":26,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2016,2,5]],"date-time":"2016-02-05T00:00:00Z","timestamp":1454630400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Cardiology"],"published-print":{"date-parts":[[2016,4]]},"abstract":"ABSTRACT<\/jats:title>Background<\/jats:title>Compared with medical therapy, percutaneous coronary intervention (PCI<\/jats:styled-content>) does not reduce mortality or myocardial infarction in patients with stable angina. Therefore, PCI<\/jats:styled-content> should be guided by refractory anginal symptoms and not just lesion characteristics.<\/jats:p><\/jats:sec>Hypothesis<\/jats:title>We hypothesized that angiographic lesion characteristics and stress test results would have a greater role in the decision to proceed with PCI than would symptom severity.<\/jats:p><\/jats:sec>Methods<\/jats:title>We performed a retrospective cohort study of patients undergoing elective cardiac catheterization and possible PCI<\/jats:styled-content> at an academic medical center. Anginal symptoms, optimal medical therapy, antianginal therapy, stress test results, and angiographic lesions (including American College of Cardiology\/American Heart Association [ACC<\/jats:styled-content>\/AHA<\/jats:styled-content>] lesion type) were analyzed. Logistic regression was used to determine predictors of medical management among patients not referred for coronary artery bypass surgery.<\/jats:p><\/jats:sec>Results<\/jats:title>Of the 207 patients with obstructive lesions amenable to PCI<\/jats:styled-content>, 163 underwent PCI<\/jats:styled-content> and 44 were referred to medical therapy. In the multivariable logistic model, the following variables were associated with medical management: advancing age (odds ratio [OR<\/jats:styled-content>] per 1 year: 0.94, 95% confidence interval [CI<\/jats:styled-content>]: 0.91\u20100.98), chronic kidney disease (OR<\/jats:styled-content>: 0.23, 95% CI<\/jats:styled-content>: 0.06\u20100.95), distal location (OR<\/jats:styled-content>: 0.21, 95% CI<\/jats:styled-content>: 0.09\u20100.48), and ACC<\/jats:styled-content>\/AHA<\/jats:styled-content> type C lesion (OR<\/jats:styled-content>: 0.08, 95% CI<\/jats:styled-content>: 0.03\u20100.22). There was no association with sex, race, symptoms, optimal medical therapy, maximal antianginal therapy, referral status, or type of interventional cardiologist (academic vs private practice).<\/jats:p><\/jats:sec>Conclusions<\/jats:title>For patients undergoing cardiac catheterization for stable angina, the decision to proceed to PCI<\/jats:styled-content> vs medical management appears to depend largely on patient and angiographic characteristics, but not on symptoms or ischemia. Distal and high\u2010risk lesions (ACC<\/jats:styled-content>\/AHA<\/jats:styled-content> type C) are more often referred for medical therapy.<\/jats:p><\/jats:sec>","DOI":"10.1002\/clc.22510","type":"journal-article","created":{"date-parts":[[2016,2,5]],"date-time":"2016-02-05T18:10:34Z","timestamp":1454695834000},"page":"207-214","source":"Crossref","is-referenced-by-count":4,"title":["Predictors of Medical Management in Patients Undergoing Elective Cardiac Catheterization for Chronic Ischemic Heart Disease"],"prefix":"10.1002","volume":"39","author":[{"given":"Auras R.","family":"Atreya","sequence":"first","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine Baystate Medical Center Springfield Massachusetts"},{"name":"Department of Internal Medicine Tufts University School of Medicine Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Senthil K.","family":"Sivalingam","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine Baystate Medical Center Springfield Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sonali","family":"Arora","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine Baystate Medical Center Springfield Massachusetts"},{"name":"Department of Internal Medicine Tufts University School of Medicine Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mohammad Amin","family":"Kashef","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine Baystate Medical Center Springfield Massachusetts"},{"name":"Department of Internal Medicine Tufts University School of Medicine Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janice","family":"Fitzgerald","sequence":"additional","affiliation":[{"name":"Faculty and Resident Development, Department of Internal Medicine Baystate Medical Center Springfield Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Visintainer","sequence":"additional","affiliation":[{"name":"Division of Epidemiology and Biostatistics Baystate Medical Center Springfield Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amir","family":"Lotfi","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular Medicine, Department of Internal Medicine Baystate Medical Center Springfield Massachusetts"},{"name":"Department of Internal Medicine Tufts University School of Medicine Boston Massachusetts"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Michael B.","family":"Rothberg","sequence":"additional","affiliation":[{"name":"Center for Value\u2010Based Care Research Medicine Institute, Cleveland Clinic Cleveland Ohio"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,2,5]]},"reference":[{"key":"e_1_2_6_2_1","first-page":"e2","article-title":"Heart disease and stroke statistics\u20142012 update: a report from the American Heart Association [published correction appears in Circulation. 2012;125:e1002]","volume":"125","author":"Roger VL","year":"2012","journal-title":"Circulation."},{"key":"e_1_2_6_3_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2011.916"},{"key":"e_1_2_6_4_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.109.192663"},{"key":"e_1_2_6_5_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIR.0b013e318256f1e0"},{"key":"e_1_2_6_6_1","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCULATIONAHA.104.521864"},{"key":"e_1_2_6_7_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa070829"},{"key":"e_1_2_6_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/jamainternmed.2013.12855"},{"key":"e_1_2_6_9_1","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa072771"},{"key":"e_1_2_6_10_1","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24376"},{"key":"e_1_2_6_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjcard.2010.01.008"},{"key":"e_1_2_6_12_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.297.18.1985"},{"key":"e_1_2_6_13_1","doi-asserted-by":"publisher","DOI":"10.1016\/0735-1097(95)00228-V"},{"key":"e_1_2_6_14_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2008.10.005"},{"key":"e_1_2_6_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.12.001"},{"key":"e_1_2_6_16_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11606-008-0706-x"},{"key":"e_1_2_6_17_1","unstructured":"The ISCHEMIA Study.http:\/\/www.ischemiatrial.org. 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