A Clinical Randomized Trial to Evaluate the Safety of a Noninvasive Approach in High-Risk Patients Undergoing Major Vascular SurgeryThe DECREASE-V Pilot Study
Don Poldermans, MD*,*,
Olaf Schouten, MD ,
Radosav Vidakovic, MD ,
Jeroen J. Bax, MD ,
Ian R. Thomson, MD||,
Sanne E. Hoeks, MSc ,
Harm H.H. Feringa, MD ,
Martin Dunkelgrün, MD ,
Peter de Jaegere, MD ,
Alexander Maat, MD¶,
Marc R.H.M. van Sambeek, MD ,
Miklos D. Kertai, MD*,
Eric Boersma, PhD for the DECREASE Study Group
* Department of Anesthesiology, Erasmus Medical Center, Rotterdam, the Netherlands
Department of Vascular Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
Department of Cardiology, Erasmus Medical Center, Rotterdam, the Netherlands
¶ Department of Cardiothoracic Surgery, Erasmus Medical Center, Rotterdam, the Netherlands
Department of Cardiology, Leiden University Medical Center, Leiden, the Netherlands
|| Department of Anesthesiology, University of Alberta, Winnipeg, Manitoba, Canada.

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Figure 1 Flowchart of the Study
Cardiac risk factors included age over 70 years, angina pectoris, prior myocardial infarction (MI) on the basis of history or a finding of pathologic Q waves on electrocardiography, compensated congestive heart failure or a history of congestive heart failure, current treatment for diabetes mellitus, renal dysfunction (serum creatinine >160 µmol/l), and prior stroke or transient ischemic attack. Patients with >3 risk factors and extensive ischemia were randomly (1:1) assigned to coronary revascularization.
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Figure 2 Incidence of All-Cause Death or Myocardial Infarction During 1-Year Follow-Up According to the Allocated Strategy in Patients With 3 or More Cardiac Risk Factors With Extensive Stress-Induced Ischemia
Light line = best medical treatment only; dark line = best medical treatment and prophylactic revascularization.
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