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In Reply Drs Civeira and Mateo-Gallego point out the contradictory messages between our article and the article by Polonsky et al1 and state that “contradictory messages [on revascularization] may contribute to this important problem [of inappropriate coronary revascularization].” The concern stems from a case described by Polonsky et al of a 53-year-old man with intermediate pretest probability of coronary artery disease and mild angina who had excellent work capacity and low prognostic risk on an ETT but 1.5-mm downsloping ST-segment depressions in multiple leads that began during recovery. He was referred for coronary angiography, found to have multivessel disease, and underwent CABG surgery.
Bangalore S, Maron DJ, Hochman JS. Treatment of Patients With Stable Ischemic Heart Disease—Reply. JAMA. 2016;315(17):1905–1906. doi:10.1001/jama.2016.0698
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