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Causes of Death Following PCI Versus CABG in Complex CAD 5-Year Follow-Up of SYNTAX
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- Milojevic, Milan (författare)
- Erasmus Univ, Med Ctr, Dept Cardiothorac Surg, Rotterdam, Netherlands.
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- Head, Stuart J. (författare)
- Erasmus Univ, Med Ctr, Dept Cardiothorac Surg, Rotterdam, Netherlands.
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- Parasca, Catalina A. (författare)
- Erasmus Univ, Med Ctr, Dept Cardiothorac Surg, Rotterdam, Netherlands.
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- Serruys, Patrick W. (författare)
- Erasmus Univ, Med Ctr, Dept Cardiol, Rotterdam, Netherlands.
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- Mohr, Friedrich W. (författare)
- Herzzentrum Univ Leipzig, Dept Cardiovasc Surg, Leipzig, Germany.
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- Morice, Marie-Claude (författare)
- Hop Prive Jacques Cartier, Inst Cardiovasc Paris Sud, Gen Sante, Massy, France.
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- Mack, Michael J. (författare)
- Baylor Healthcare Syst, Heart Hosp Baylor Plano, Dept Cardiovasc Surg, Plano, TX USA.
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- Ståhle, Elisabeth (författare)
- Uppsala universitet,Thoraxkirurgi
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- Feldman, E. (författare)
- Northwestern Univ, Evanston Hosp, Div Cardiol, Evanston, IL 60201 USA.
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Feldman, Ted E. (författare)
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- Dawkins, Keith D. (författare)
- Boston Sci Corp, Natick, MA USA.
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- Colombo, Antonio (författare)
- EMO GVM Ctr Cuore Columbus, Intervent Cardiol Unit, Milan, Italy.;Ist Sci San Raffaele, Intervent Cardiol Unit, I-20132 Milan, Italy.
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- Kappetein, A. Pieter (författare)
- Erasmus Univ, Med Ctr, Dept Cardiothorac Surg, Rotterdam, Netherlands.
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- Holmes, David R., Jr. (författare)
- Mayo Clin Rochester, Div Cardiovasc Dis & Internal Med, Rochester, MN 55905 USA.
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Erasmus Univ, Med Ctr, Dept Cardiothorac Surg, Rotterdam, Netherlands Erasmus Univ, Med Ctr, Dept Cardiol, Rotterdam, Netherlands. (creator_code:org_t)
- Elsevier BV, 2016
- 2016
- Engelska.
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Ingår i: Journal of the American College of Cardiology. - : Elsevier BV. - 0735-1097 .- 1558-3597. ; 67:1, s. 42-55
- Relaterad länk:
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https://doi.org/10.1...
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
Ämnesord
Stäng
- BACKGROUND There are no data available on specific causes of death from randomized trials that have compared coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI). OBJECTIVES The purpose of this study was to investigate specific causes of death, and its predictors, after revascularization for complex coronary disease in patients. METHODS An independent Clinical Events Committee consisting of expert physicians who were blinded to the study treatment subclassified causes of death as cardiovascular (cardiac and vascular), noncardiovascular, or undetermined according to the trial protocol. Cardiac deaths were classified as sudden cardiac, related to myocardial infarction (MI), and other cardiac deaths. RESULTS In the randomized cohort, there were 97 deaths after CABG and 123 deaths after PCI during a 5-year follow-up. After CABG, 49.4% of deaths were cardiovascular, with the greatest cause being heart failure, arrhythmia, or other causes (24.6%), whereas after PCI, the majority of deaths were cardiovascular (67.5%) and as a result of MI (29.3%). The cumulative incidence rates of all-cause death were not significantly different between CABG and PCI (11.4% vs. 13.9%, respectively; p = 0.10), whereas there were significant differences in terms of cardiovascular (5.8% vs. 9.6%, respectively; p = 0.008) and cardiac death (5.3% vs. 9.0%, respectively; p = 0.003), which were caused primarily by a reduction in MI-related death with CABG compared with PCI (0.4% vs. 4.1%, respectively; p <0.0001). Treatment with PCI versus CABG was an independent predictor of cardiac death (hazard ratio: 1.55; 95% confidence interval: 1.09 to 2.33; p = 0.045). The difference in MI-related death was seen largely in patients with diabetes, 3-vessel disease, or high SYNTAX (TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries) trial scores. CONCLUSIONS During a 5-year follow-up, CABG in comparison with PCI was associated with a significantly reduced rate of MI-related death, which was the leading cause of death after PCI. Treatments following PCI should target reducing post-revascularization spontaneous MI. Furthermore, secondary preventive medication remains essential in reducing events post-revascularization. (TAXUS Drug-Eluting Stent Versus Coronary Artery Bypass Surgery for the Treatment of Narrowed Arteries [SYNTAX]; NCT00114972)
Ämnesord
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Nyckelord
- cardiac death
- cause of death
- coronary artery bypass grafting
- heart failure
- myocardial infarction
- percutaneous coronary intervention
- stroke
- sudden death
- SYNTAX
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Milojevic, Milan
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Head, Stuart J.
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Parasca, Catalin ...
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Serruys, Patrick ...
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Mohr, Friedrich ...
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Morice, Marie-Cl ...
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Mack, Michael J.
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Ståhle, Elisabet ...
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Feldman, E.
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Feldman, Ted E.
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Dawkins, Keith D ...
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Colombo, Antonio
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Kappetein, A. Pi ...
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Holmes, David R. ...
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