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Comparison of coron...
Comparison of coronary bypass surgery with drug-eluting stenting for the treatment of left main and/or three-vessel disease : 3-year follow-up of the SYNTAX trial
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Kappetein, Arie Pieter (författare)
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Feldman, Ted E. (författare)
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Mack, Michael J. (författare)
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Morice, Marie-Claude (författare)
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Holmes, David R. (författare)
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- Ståhle, Elisabeth (författare)
- Uppsala universitet,Institutionen för kirurgiska vetenskaper
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Dawkins, Keith D. (författare)
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Mohr, Friedrich W. (författare)
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Serruys, Patrick W. (författare)
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Colombo, Antonio (författare)
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(creator_code:org_t)
- 2011-06-22
- 2011
- Engelska.
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Ingår i: European Heart Journal. - : Oxford University Press (OUP). - 0195-668X .- 1522-9645. ; 32:17, s. 2125-2134
- Relaterad länk:
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https://academic.oup...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
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- Aims: Long-term randomized comparisons of percutaneous coronary intervention (PCI) to coronary artery bypass grafting (CABG) in left main coronary (LM) disease and/or three-vessel disease (3VD) patients have been limited. This analysis compares 3-year outcomes in LM and/or 3VD patients treated with CABG or PCI with TAXUS Express stents. Methods and results: SYNTAX is an 85-centre randomized clinical trial (n = 1800). Prospectively screened, consecutive LM and/or 3VD patients were randomized if amenable to equivalent revascularization using either technique; if not, they were entered into a registry. Patients in the randomized cohort will continue to be followed for 5 years. At 3 years, major adverse cardiac and cerebrovascular events [MACCE: death, stroke, myocardial infarction (MI), and repeat revascularization; CABG 20.2% vs. PCI 28.0%, P < 0.001], repeat revascularization (10.7 vs. 19.7%, P < 0.001), and MI (3.6 vs. 7.1%, P = 0.002) were elevated in the PCI arm. Rates of the composite safety endpoint (death/stroke/MI 12.0 vs. 14.1%, P = 0.21) and stroke alone (3.4 vs. 2.0%, P = 0.07) were not significantly different between treatment groups. Major adverse cardiac and cerebrovascular event rates were not significantly different between arms in the LM subgroup (22.3 vs. 26.8%, P = 0.20) but were higher with PCI in the 3VD subgroup (18.8 vs. 28.8%, P < 0.001). Conclusions: At 3 years, MACCE was significantly higher in PCI-compared with CABG-treated patients. In patients with less complex disease (low SYNTAX scores for 3VD or low/intermediate terciles for LM patients), PCI is an acceptable revascularization, although longer follow-up is needed to evaluate these two revascularization strategies.
Nyckelord
- SYNTAX
- Left main
- Multivessel disease
- PCI
- CABG
- Stent thrombosis
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- art (ämneskategori)
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Kappetein, Arie ...
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Feldman, Ted E.
-
Mack, Michael J.
-
Morice, Marie-Cl ...
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Holmes, David R.
-
Ståhle, Elisabet ...
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visa fler...
-
Dawkins, Keith D ...
-
Mohr, Friedrich ...
-
Serruys, Patrick ...
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Colombo, Antonio
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visa färre...
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European Heart J ...
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Uppsala universitet