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Geographic disparit...
Geographic disparity in 10-year mortality after coronary artery revascularization in the SYNTAXES trial
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- Kageyama, Shigetaka (author)
- Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland.
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- Serruys, Patrick W. (author)
- Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland.;Imperial Coll London, Natl Heart & Lung Inst, London, England.
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- Garg, Scot (author)
- Royal Blackburn Hosp, Dept Cardiol, Blackburn, Lancs, England.
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- Ninomiya, Kai (author)
- Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland.
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- Masuda, Shinichiro (author)
- Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland.
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- Kotoku, Nozomi (author)
- Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland.
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- Colombo, Antonio (author)
- Humanitas Univ, Dept Biomed Sci, Pieve Emanuele Milan, Italy.;Humanitas Clin & Res Ctr IRCCS, Rozzano Milan, Italy.
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- Mack, Michael J. (author)
- Baylor Univ, Med Ctr, Dept Cardiothorac Surg, Dallas, TX USA.
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- Banning, Adrian P. (author)
- Oxford Univ Hosp, John Radcliffe Hosp, Dept Cardiol, Oxford, England.
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- Morice, Marie-Claude (author)
- Hop Prive Jacques Cartier, Gen Sante Massy, Dept Cardiol, Massy, France.
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- Witkowski, Adam (author)
- Natl Inst Cardiol, Dept Intervent Cardiol & Angiol, Warsaw, Poland.
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- Curzen, Nick (author)
- Univ Southampton, Fac Med, Southampton, Hants, England.;Univ Hosp Southampton NHS Trust, Cardiothorac Unit, Southampton, Hants, England.
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- Burzotta, Francesco (author)
- Univ Cattolica Sacro Cuore, Fdn Policlin Univ A Gemelli IRCCS, Inst Cardiol, Rome, Italy.
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- James, Stefan, 1964- (author)
- Uppsala universitet,Institutionen för medicinska vetenskaper
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- van Geuns, Robert-Jan (author)
- Radboud Univ Nijmegen, Dept Cardiol, Med Ctr, Nijmegen, Netherlands.
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- Davierwala, Piroze M. (author)
- Univ Toronto, Dept Surg, Toronto, ON, Canada.;Toronto Gen Hosp, Peter Munk Cardiac Ctr, Div Cardiovasc Surg, Toronto, ON, Canada.;Univ Hlth Network, Toronto, ON, Canada.
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- Holmes, David R., Jr. (author)
- Mayo Clin, Dept Cardiovasc Dis & Internal Med, Rochester, MN USA.
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- Wood, David A. (author)
- Imperial Coll London, Natl Heart & Lung Inst, London, England.;Natl Univ Ireland, Natl Inst Prevent & Cardiovasc Hlth, Galway, Ireland.
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- McEvoy, John William (author)
- Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland.;Natl Univ Ireland, Natl Inst Prevent & Cardiovasc Hlth, Galway, Ireland.
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- Onuma, Yoshinobu (author)
- Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland.
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Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland.;Imperial Coll London, Natl Heart & Lung Inst, London, England. (creator_code:org_t)
- Elsevier, 2022
- 2022
- English.
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In: International Journal of Cardiology. - : Elsevier. - 0167-5273 .- 1874-1754. ; 368, s. 28-38
- Related links:
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https://urn.kb.se/re...
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https://doi.org/10.1...
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Abstract
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- Aims: To investigate geographic disparity in long-term mortality following revascularization in patients with complex coronary artery disease (CAD).Methods and results: The SYNTAXES trial randomized 1800 patients with three-vessel and/or left main CAD to percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) and assessed their survival at 10 years. Patients were stratified according to the region of recruitment: North America (N-A, n = 245), Eastern Europe (E-E, n = 189), Northern Europe (N-E, n = 425), Southern Europe (S-E, n = 263), and Western Europe (W-E, n = 678), which also served as the reference group. Compared to W-E, patients were younger in E-E (62 vs 65 years, p < 0.001), and less frequently male in N-A (65.3% vs 79.6%, p < 0.001). Diabetes (16.0% vs 25.4%, p < 0.001) and peripheral vascular disease (6.8% vs 10.9%, p = 0.025) were less frequent in N-E than W-E. Ejection fraction was highest in W-E (62% vs 56%, p < 0.001). Compared to W-E, the mean anatomic SYNTAX score was higher in S-E (29 vs 31, p = 0.008) and lower in N-A (26, p < 0.001). Crude ten-year mortality was similar in N-A (31.6%), and W-E (30.7%), and significantly lower in E-E (22.5%, p = 0.041), N-E (21.9%, p = 0.003) and S-E (22.0%, p = 0.014). Compared to W-E, adjusted mortality in N-E (HR 0.85, p = 0.019) and S-E (HR 0.72, p = 0.043) remain significantly lower after adjustment for pre-and peri-procedural factors, but no significant interaction (Pinteraction = 0.728) between region and modality of revascularization was seen.Conclusion: In the era of globalization, knowledge, and understanding of geographic disparity are of paramount importance for the correct interpretation of global studies.
Subject headings
- MEDICIN OCH HÄLSOVETENSKAP -- Klinisk medicin -- Kardiologi (hsv//swe)
- MEDICAL AND HEALTH SCIENCES -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)
Keyword
- Geographic disparity
- Revascularization
- Complex coronary artery disease
- Ten-year mortality
Publication and Content Type
- ref (subject category)
- art (subject category)
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Kageyama, Shiget ...
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Serruys, Patrick ...
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Garg, Scot
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Ninomiya, Kai
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Masuda, Shinichi ...
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Kotoku, Nozomi
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Colombo, Antonio
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Mack, Michael J.
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Banning, Adrian ...
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Morice, Marie-Cl ...
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Witkowski, Adam
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Curzen, Nick
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Burzotta, France ...
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James, Stefan, 1 ...
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van Geuns, Rober ...
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Davierwala, Piro ...
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Holmes, David R. ...
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Wood, David A.
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McEvoy, John Wil ...
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Onuma, Yoshinobu
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