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Utility of the ACC/...
Utility of the ACC/AHA Lesion Classification to Predict Outcomes After Contemporary DES Treatment: Individual Patient Data Pooled Analysis From 7 Randomized Trials.
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Konigstein, Maayan (författare)
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- Redfors, Björn (författare)
- Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine
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Zhang, Zixuan (författare)
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Kotinkaduwa, Lak N (författare)
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Mintz, Gary S (författare)
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Smits, Pieter C (författare)
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Serruys, Patrick W (författare)
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von Birgelen, Clemens (författare)
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Madhavan, Mahesh V (författare)
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Golomb, Mordechai (författare)
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Ben-Yehuda, Ori (författare)
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Mehran, Roxana (författare)
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Leon, Martin B (författare)
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Stone, Gregg W (författare)
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- 2022
- 2022
- Engelska.
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Ingår i: Journal of the American Heart Association. - 2047-9980.
- Relaterad länk:
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https://gup.ub.gu.se...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Background Use of the modified American College of Cardiology (ACC)/American Heart Association (AHA) lesion classification as a prognostic tool to predict short- and long-term clinical outcomes after percutaneous coronary intervention in the modern drug-eluting stent era is uncertain. Methods and Results Patient-level data from 7 prospective, randomized trials were pooled. Clinical outcomes of patients undergoing single lesion percutaneous coronary intervention with second-generation drug-eluting stent were analyzed according to modified ACC/AHA lesion class. The primary end point was target lesion failure (TLF: composite of cardiac death, target vessel myocardial infarction, or ischemia-driven target lesion revascularization). Clinical outcomes to 5 years were compared between patients treated for noncomplex (class A/B1) versus complex (class B2/C) lesions. Eight thousand five hundred sixteen patients (age 63.1±10.8 years, 70.5% male) were analyzed. Lesions were classified as A, B1, B2, and C in 7.9%, 28.5%, 33.7%, and 30.0% of cases, respectively. Target lesion failure was higher in patients undergoing percutaneous coronary intervention of complex versus noncomplex lesions at 30 days (2.0% versus 1.1%, P=0.004), at 1 year (4.6% versus 3.0%, P=0.0005), and at 5 years (12.4% versus 9.2%, P=0.0001). By multivariable analysis, treatment of ACC/AHA class B2/C lesions was significantly associated with higher rate of 5-year target lesion failure (adjusted hazard ratio, 1.39 [95% CI, 1.17-1.64], P=0.0001) driven by significantly higher rates of target vessel myocardial infarction and ischemia-driven target lesion revascularization. Conclusions In this pooled large-scale analysis, treating complex compared with noncomplex lesions according to the modified ACC/AHA classification with second-generation drug-eluting stent was associated with worse 5-year clinical outcomes. This historical classification system may be useful in the contemporary era for predicting early and late outcomes following percutaneous coronary intervention.
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine (hsv//eng)
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Konigstein, Maay ...
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Redfors, Björn
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Zhang, Zixuan
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Kotinkaduwa, Lak ...
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Mintz, Gary S
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Smits, Pieter C
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visa fler...
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Serruys, Patrick ...
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von Birgelen, Cl ...
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Madhavan, Mahesh ...
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Golomb, Mordecha ...
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Ben-Yehuda, Ori
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Mehran, Roxana
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Leon, Martin B
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Stone, Gregg W
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visa färre...
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Göteborgs universitet