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Sökning: WFRF:(Diletti Roberto) > (2013) > The Negative Impact...

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00004459naa a2200517 4500
001oai:DiVA.org:uu-190955
003SwePub
008130109s2013 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-1909552 URI
0247 a https://doi.org/10.1016/j.jacc.2012.10.0172 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Farooq, Vasim4 aut
2451 0a The Negative Impact of Incomplete Angiographic Revascularization on Clinical Outcomes and Its Association With Total Occlusions :b The SYNTAX (Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) Trial
264 1b Elsevier BV,c 2013
338 a print2 rdacarrier
520 a OBJECTIVES:The study sought to evaluate the clinical impact of angiographic complete (CR) and incomplete (ICR) revascularization and its association with the presence of total occlusions (TO), after percutaneous coronary intervention (PCI) or coronary artery bypass graft (CABG) surgery in the "all-comers" SYNTAX (Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery) trial.BACKGROUND:In patients with complex coronary artery disease undergoing PCI or CABG, the long-term prognostic implications of CR versus ICR is unsettled.METHODS:In this post hoc study, consisting of randomized (n = 1,800) and nested PCI (n = 198) and CABG (n = 649) registries, 4-year clinical outcomes were compared in groups, with and without angiographic CR, in the PCI and CABG arms. Clinical outcomes were analyzed with Kaplan-Meier estimates, log-rank comparisons, and Cox regression analyses. Multivariate predictors of ICR were determined. Similar analyses were undertaken in the TO and non-TO treated groups of both study arms.RESULTS:Angiographic CR was achieved in 52.8% of the PCI arm and 66.9% of the CABG arm. Within the PCI and CABG arms, ICR (compared with CR) seemed to be a surrogate marker of a greater burden of anatomical coronary complexity and clinical comorbidity and was associated with significantly higher frequencies of 4-year mortality, all-cause revascularization, stent thrombosis (PCI arm), and major adverse cardiac and cerebrovascular events. The presence of a TO was the strongest independent predictor of ICR after PCI (hazard ratio: 2.70, 95% confidence interval: 1.98 to 3.67, p < 0.001). Eight hundred and forty patients (PCI: 26.3%, CABG: 36.4%, p < 0.001) were identified to have 1,007 TOs, with 68.1% of TOs located in the proximal-mid coronary vasculature. The findings associating ICR (compared with CR) with higher frequencies of 4-year mortality and major adverse cardiac and cerebrovascular events remained consistent in the TO-treated groups in the PCI and CABG arms.CONCLUSIONS:Within the PCI and CABG arms of the all-comers SYNTAX trial, angiographically determined ICR has a detrimental impact on long-term clinical outcomes, including mortality. This effect remained consistent in patients with and without TOs.
7001 a Serruys, Patrick W4 aut
7001 a Garcia-Garcia, Hector M4 aut
7001 a Zhang, Yaojun4 aut
7001 a Bourantas, Christos V4 aut
7001 a Holmes, David R4 aut
7001 a Mack, Michael4 aut
7001 a Feldman, Ted4 aut
7001 a Morice, Marie-Claude4 aut
7001 a Ståhle, Elisabethu Uppsala universitet,Thoraxkirurgi4 aut0 (Swepub:uu)elsta102
7001 a James, Stefanu Uppsala universitet,Kardiologi,Uppsala kliniska forskningscentrum (UCR)4 aut0 (Swepub:uu)stjam367
7001 a Colombo, Antonio4 aut
7001 a Diletti, Roberto4 aut
7001 a Papafaklis, Michail I4 aut
7001 a de Vries, Ton4 aut
7001 a Morel, Marie-Angèle4 aut
7001 a van Es, Gerrit Anne4 aut
7001 a Mohr, Friedrich W4 aut
7001 a Dawkins, Keith D4 aut
7001 a Kappetein, Arie-Pieter4 aut
7001 a Sianos, Georgiosu University Hospital Uppsala, Uppsala, Sweden4 aut
7001 a Boersma, Eric4 aut
7102 a Uppsala universitetb Thoraxkirurgi4 org
7730 t Journal of the American College of Cardiologyd : Elsevier BVg 61:3, s. 282-294q 61:3<282-294x 0735-1097x 1558-3597
8564 u https://doi.org/10.1016/j.jacc.2012.10.017
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-190955
8564 8u https://doi.org/10.1016/j.jacc.2012.10.017

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