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FältnamnIndikatorerMetadata
00005064naa a2200625 4500
001oai:gup.ub.gu.se/285857
003SwePub
008240528s2019 | |||||||||||000 ||eng|
0247 a https://gup.ub.gu.se/publication/2858572 URI
0247 a https://doi.org/10.1016/S0140-6736(19)31997-X2 DOI
040 a (SwePub)gu
041 a eng
042 9 SwePub
072 7a ref2 swepub-contenttype
072 7a art2 swepub-publicationtype
1001 a Thuijs, Daniel J F M4 aut
2451 0a Percutaneous coronary intervention versus coronary artery bypass grafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial.
264 1c 2019
520 a The Synergy between PCI with Taxus and Cardiac Surgery (SYNTAX) trial was a non-inferiority trial that compared percutaneous coronary intervention (PCI) using first-generation paclitaxel-eluting stents with coronary artery bypass grafting (CABG) in patients with de-novo three-vessel and left main coronary artery disease, and reported results up to 5 years. We now report 10-year all-cause death results.The SYNTAX Extended Survival (SYNTAXES) study is an investigator-driven extension of follow-up of a multicentre, randomised controlled trial done in 85 hospitals across 18 North American and European countries. Patients with de-novo three-vessel and left main coronary artery disease were randomly assigned (1:1) to the PCI group or CABG group. Patients with a history of PCI or CABG, acute myocardial infarction, or an indication for concomitant cardiac surgery were excluded. The primary endpoint of the SYNTAXES study was 10-year all-cause death, which was assessed according to the intention-to-treat principle. Prespecified subgroup analyses were performed according to the presence or absence of left main coronary artery disease and diabetes, and according to coronary complexity defined by core laboratory SYNTAX score tertiles. This study is registered with ClinicalTrials.gov, NCT03417050.From March, 2005, to April, 2007, 1800 patients were randomly assigned to the PCI (n=903) or CABG (n=897) group. Vital status information at 10 years was complete for 841 (93%) patients in the PCI group and 848 (95%) patients in the CABG group. At 10 years, 244 (27%) patients had died after PCI and 211 (24%) after CABG (hazard ratio 1·17 [95% CI 0·97-1·41], p=0·092). Among patients with three-vessel disease, 151 (28%) of 546 had died after PCI versus 113 (21%) of 549 after CABG (hazard ratio 1·41 [95% CI 1·10-1·80]), and among patients with left main coronary artery disease, 93 (26%) of 357 had died after PCI versus 98 (28%) of 348 after CABG (0·90 [0·68-1·20], pinteraction=0·019). There was no treatment-by-subgroup interaction with diabetes (pinteraction=0·66) and no linear trend across SYNTAX score tertiles (ptrend=0·30).At 10 years, no significant difference existed in all-cause death between PCI using first-generation paclitaxel-eluting stents and CABG. However, CABG provided a significant survival benefit in patients with three-vessel disease, but not in patients with left main coronary artery disease.German Foundation of Heart Research (SYNTAXES study, 5-10-year follow-up) and Boston Scientific Corporation (SYNTAX study, 0-5-year follow-up).
650 7a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicin0 (SwePub)3022 hsv//swe
650 7a MEDICAL AND HEALTH SCIENCESx Clinical Medicine0 (SwePub)3022 hsv//eng
653 a Aged
653 a Coronary Artery Bypass
653 a Coronary Artery Disease
653 a mortality
653 a pathology
653 a surgery
653 a Drug-Eluting Stents
653 a Female
653 a Follow-Up Studies
653 a Humans
653 a Male
653 a Middle Aged
653 a Percutaneous Coronary Intervention
653 a Survival Rate
653 a Treatment Outcome
7001 a Kappetein, A Pieter4 aut
7001 a Serruys, Patrick W4 aut
7001 a Mohr, Friedrich-Wilhelm4 aut
7001 a Morice, Marie-Claude4 aut
7001 a Mack, Michael J4 aut
7001 a Holmes, David R4 aut
7001 a Curzen, Nick4 aut
7001 a Davierwala, Piroze4 aut
7001 a Noack, Thilo4 aut
7001 a Milojevic, Milan4 aut
7001 a Dawkins, Keith D4 aut
7001 a da Costa, Bruno R4 aut
7001 a Jüni, Peter4 aut
7001 a Head, Stuart J4 aut
7001 a Jeppsson, Anders,d 1960u Gothenburg University,Göteborgs universitet,Institutionen för medicin, avdelningen för molekylär och klinisk medicin,Institute of Medicine, Department of Molecular and Clinical Medicine4 aut0 (Swepub:gu)xjepan
7102 a Göteborgs universitetb Institutionen för medicin, avdelningen för molekylär och klinisk medicin4 org
7730 t Lancet (London, England)g 394:10206, s. 1325-1334q 394:10206<1325-1334x 1474-547X
8564 8u https://gup.ub.gu.se/publication/285857
8564 8u https://doi.org/10.1016/S0140-6736(19)31997-X

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