RT Journal A1 Kostis WJ, Schulman SP T1 DOcumenting ischemia prior to elective percutaneous coronary intervention JF JAMA JO JAMA YR 2009 FD March 11 VO 301 IS 10 SP 1018 OP 1019 DO 10.1001/jama.2009.258 UL http://dx.doi.org/10.1001/jama.2009.258 AB To the Editor: In their observational cohort study of Medicare fee-for-service beneficiaries aged 65 years or older, Dr Lin and colleagues1 reported that the majority of patients with stable coronary artery disease did not undergo stress testing to document ischemia within 90 days prior to elective percutaneous coronary intervention (PCI). The authors state that for patients with stable angina, any vessels to be dilated must be shown to be “associated with a moderate to severe degree of ischemia on noninvasive testing” (referring to the class IIa recommendation in section 5.1 on page e205 of the guidelines from the American College of Cardiology, the American Heart Association, and the Society for Cardiovascular Angiography and Intervention [ACC/AHA/SCAI]2).