SwePub
Sök i LIBRIS databas

  Utökad sökning

WFRF:(Picard Daniel)
 

Sökning: WFRF:(Picard Daniel) > Outcomes in the ISC...

LIBRIS Formathandbok  (Information om MARC21)
FältnamnIndikatorerMetadata
00006145naa a2200601 4500
001oai:DiVA.org:uu-457629
003SwePub
008211101s2021 | |||||||||||000 ||eng|
0247 a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4576292 URI
0247 a https://doi.org/10.1161/CIRCULATIONAHA.120.0497552 DOI
040 a (SwePub)uu
041 a engb eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Reynolds, Harmony R.u NYU, Grossman Sch Med, New York, NY USA.4 aut
2451 0a Outcomes in the ISCHEMIA Trial Based on Coronary Artery Disease and Ischemia Severity
264 1b Lippincott Williams & Wilkins,c 2021
338 a print2 rdacarrier
520 a BACKGROUND: The ISCHEMIA trial (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) postulated that patients with stable coronary artery disease (CAD) and moderate or severe ischemia would benefit from revascularization. We investigated the relationship between severity of CAD and ischemia and trial outcomes, overall and by management strategy.METHODS: In total, 5179 patients with moderate or severe ischemia were randomized to an initial invasive or conservative management strategy. Blinded, core laboratory-interpreted coronary computed tomographic angiography was used to assess anatomic eligibility for randomization. Extent and severity of CAD were classified with the modified Duke Prognostic Index (n=2475, 48%). Ischemia severity was interpreted by independent core laboratories (nuclear, echocardiography, magnetic resonance imaging, exercise tolerance testing, n=5105, 99%). We compared 4-year event rates across subgroups defined by severity of ischemia and CAD. The primary end point for this analysis was all-cause mortality. Secondary end points were myocardial infarction (MI), cardiovascular death or MI, and the trial primary end point (cardiovascular death, MI, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest).RESULTS: Relative to mild/no ischemia, neither moderate ischemia nor severe ischemia was associated with increased mortality (moderate ischemia hazard ratio [HR], 0.89 [95% CI, 0.61-1.30]; severe ischemia HR, 0.83 [95% CI, 0.57-1.21]; P=0.33). Nonfatal MI rates increased with worsening ischemia severity (HR for moderate ischemia, 1.20 [95% CI, 0.86-1.69] versus mild/no ischemia; HR for severe ischemia, 1.37 [95% CI, 0.98-1.91]; P=0.04 for trend, P=NS after adjustment for CAD). Increasing CAD severity was associated with death (HR, 2.72 [95% CI, 1.06-6.98]) and MI (HR, 3.78 [95% CI, 1.63-8.78]) for the most versus least severe CAD subgroup. Ischemia severity did not identify a subgroup with treatment benefit on mortality, MI, the trial primary end point, or cardiovascular death or MI. In the most severe CAD subgroup (n=659), the 4-year rate of cardiovascular death or MI was lower in the invasive strategy group (difference, 6.3% [95% CI, 0.2%-12.4%]), but 4-year all-cause mortality was similar.CONCLUSIONS: Ischemia severity was not associated with increased risk after adjustment for CAD severity. More severe CAD was associated with increased risk. Invasive management did not lower all-cause mortality at 4 years in any ischemia or CAD subgroup.
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng
653 a coronary artery bypass
653 a coronary artery disease
653 a ischemia
653 a myocardial revascularization
653 a percutaneous coronary intervention
7001 a Shaw, Leslee J.u New York Presbyterian Hosp, Weill Cornell Med, New York, NY USA.4 aut
7001 a Min, James K.u Cleerly Inc, New York, NY USA.4 aut
7001 a Page, Courtney B.u Duke Clin Res Inst, Durham, NC USA.4 aut
7001 a Berman, Daniel S.u Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA.4 aut
7001 a Chaitman, Bernard R.u St Louis Univ, Sch Med, Ctr Comprehens Cardiovasc Care, St Louis, MO USA.4 aut
7001 a Picard, Michael H.u Massachusetts Gen Hosp, Boston, MA 02114 USA.;Harvard Med Sch, Boston, MA 02115 USA.4 aut
7001 a Kwong, Raymond Y.u Brigham & Womens Hosp, 75 Francis St, Boston, MA 02115 USA.4 aut
7001 a O'Brien, Sean M.u Duke Clin Res Inst, Durham, NC USA.4 aut
7001 a Huang, Zhenu Duke Clin Res Inst, Durham, NC USA.4 aut
7001 a Mark, Daniel B.u Duke Clin Res Inst, Durham, NC USA.4 aut
7001 a Nath, Ranjit K.u Dr Ram Manohar Lohia Hosp, New Delhi, India.4 aut
7001 a Dwivedi, Sudhanshu K.u King Georges Med Univ, Lucknow, Uttar Pradesh, India.4 aut
7001 a Smanio, Paola E. P.u Inst Dante Pazzanese Cardiol Fleury Med, Sao Paulo, Brazil.4 aut
7001 a Stone, Peter H.u Brigham & Womens Hosp, 75 Francis St, Boston, MA 02115 USA.4 aut
7001 a Held, Claes,d 1956-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi4 aut0 (Swepub:uu)clahe947
7001 a Keltai, Matyasu Semmelweis Univ, Budapest, Hungary.4 aut
7001 a Bangalore, Sripalu NYU, Grossman Sch Med, New York, NY USA.4 aut
7001 a Newman, Jonathan D.u NYU, Grossman Sch Med, New York, NY USA.4 aut
7001 a Spertus, John A.u Univ Missouri, St Lukes Midamer Heart Inst, Kansas City, KS USA.4 aut
7001 a Stone, Gregg W.u Icahn Sch Med Mt Sinai, Cardiovasc Res Fdn, New York, NY 10029 USA.4 aut
7001 a Maron, David J.u Stanford Univ, Dept Med, Stanford, CA 94305 USA.4 aut
7001 a Hochman, Judith S.u NYU, Grossman Sch Med, New York, NY USA.4 aut
7102 a NYU, Grossman Sch Med, New York, NY USA.b New York Presbyterian Hosp, Weill Cornell Med, New York, NY USA.4 org
7730 t Circulationd : Lippincott Williams & Wilkinsg 144:13, s. 1024-1038q 144:13<1024-1038x 0009-7322x 1524-4539
8564 8u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-457629
8564 8u https://doi.org/10.1161/CIRCULATIONAHA.120.049755

Hitta via bibliotek

Till lärosätets databas

Kungliga biblioteket hanterar dina personuppgifter i enlighet med EU:s dataskyddsförordning (2018), GDPR. Läs mer om hur det funkar här.
Så här hanterar KB dina uppgifter vid användning av denna tjänst.

 
pil uppåt Stäng

Kopiera och spara länken för att återkomma till aktuell vy