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Geographic disparity in 10-year mortality after coronary artery revascularization in the SYNTAXES trial

Kageyama, Shigetaka (författare)
Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland.
Serruys, Patrick W. (författare)
Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland.;Imperial Coll London, Natl Heart & Lung Inst, London, England.
Garg, Scot (författare)
Royal Blackburn Hosp, Dept Cardiol, Blackburn, Lancs, England.
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Ninomiya, Kai (författare)
Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland.
Masuda, Shinichiro (författare)
Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland.
Kotoku, Nozomi (författare)
Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland.
Colombo, Antonio (författare)
Humanitas Univ, Dept Biomed Sci, Pieve Emanuele Milan, Italy.;Humanitas Clin & Res Ctr IRCCS, Rozzano Milan, Italy.
Mack, Michael J. (författare)
Baylor Univ, Med Ctr, Dept Cardiothorac Surg, Dallas, TX USA.
Banning, Adrian P. (författare)
Oxford Univ Hosp, John Radcliffe Hosp, Dept Cardiol, Oxford, England.
Morice, Marie-Claude (författare)
Hop Prive Jacques Cartier, Gen Sante Massy, Dept Cardiol, Massy, France.
Witkowski, Adam (författare)
Natl Inst Cardiol, Dept Intervent Cardiol & Angiol, Warsaw, Poland.
Curzen, Nick (författare)
Univ Southampton, Fac Med, Southampton, Hants, England.;Univ Hosp Southampton NHS Trust, Cardiothorac Unit, Southampton, Hants, England.
Burzotta, Francesco (författare)
Univ Cattolica Sacro Cuore, Fdn Policlin Univ A Gemelli IRCCS, Inst Cardiol, Rome, Italy.
James, Stefan, 1964- (författare)
Uppsala universitet,Institutionen för medicinska vetenskaper
van Geuns, Robert-Jan (författare)
Radboud Univ Nijmegen, Dept Cardiol, Med Ctr, Nijmegen, Netherlands.
Davierwala, Piroze M. (författare)
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.
Holmes, David R., Jr. (författare)
Mayo Clin, Dept Cardiovasc Dis & Internal Med, Rochester, MN USA.
Wood, David A. (författare)
Imperial Coll London, Natl Heart & Lung Inst, London, England.;Natl Univ Ireland, Natl Inst Prevent & Cardiovasc Hlth, Galway, Ireland.
McEvoy, John William (författare)
Natl Univ Ireland, Dept Cardiol, Galway NUIG, Galway, Ireland.;Natl Univ Ireland, Natl Inst Prevent & Cardiovasc Hlth, Galway, Ireland.
Onuma, Yoshinobu (författare)
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
Engelska.
Ingår i: International Journal of Cardiology. - : Elsevier. - 0167-5273 .- 1874-1754. ; 368, s. 28-38
Relaterad länk:
https://urn.kb.se/re...
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https://doi.org/10.1...
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  • Tidskriftsartikel (refereegranskat)
Abstract Ämnesord
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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.

Ämnesord

MEDICIN OCH HÄLSOVETENSKAP  -- Klinisk medicin -- Kardiologi (hsv//swe)
MEDICAL AND HEALTH SCIENCES  -- Clinical Medicine -- Cardiac and Cardiovascular Systems (hsv//eng)

Nyckelord

Geographic disparity
Revascularization
Complex coronary artery disease
Ten-year mortality

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