Sökning: WFRF:(Todd :O) > Initial Invasive or...
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000 | 09756naa a2200973 4500 | |
001 | oai:DiVA.org:uu-411466 | |
003 | SwePub | |
008 | 200605s2020 | |||||||||||000 ||eng| | |
024 | 7 | a https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-4114662 URI |
024 | 7 | a https://doi.org/10.1056/NEJMoa19159222 DOI |
040 | a (SwePub)uu | |
041 | a engb eng | |
042 | 9 SwePub | |
072 | 7 | a ref2 swepub-contenttype |
072 | 7 | a art2 swepub-publicationtype |
100 | 1 | a Maron, David J.u Stanford Univ, Sch Med, Dept Med, 1265 Welch Rd,Med Sch Off Bldg x314, Stanford, CA 94305 USA.4 aut |
245 | 1 0 | a Initial Invasive or Conservative Strategy for Stable Coronary Disease |
264 | 1 | c 2020 |
338 | a print2 rdacarrier | |
520 | a Background: Among patients with stable coronary disease and moderate or severe ischemia, whether clinical outcomes are better in those who receive an invasive intervention plus medical therapy than in those who receive medical therapy alone is uncertain.Methods: We randomly assigned 5179 patients with moderate or severe ischemia to an initial invasive strategy (angiography and revascularization when feasible) and medical therapy or to an initial conservative strategy of medical therapy alone and angiography if medical therapy failed. The primary outcome was a composite of death from cardiovascular causes, myocardial infarction, or hospitalization for unstable angina, heart failure, or resuscitated cardiac arrest. A key secondary outcome was death from cardiovascular causes or myocardial infarction.Results: Over a median of 3.2 years, 318 primary outcome events occurred in the invasive-strategy group and 352 occurred in the conservative-strategy group. At 6 months, the cumulative event rate was 5.3% in the invasive-strategy group and 3.4% in the conservative-strategy group (difference, 1.9 percentage points; 95% confidence interval [CI], 0.8 to 3.0); at 5 years, the cumulative event rate was 16.4% and 18.2%, respectively (difference, -1.8 percentage points; 95% CI, -4.7 to 1.0). Results were similar with respect to the key secondary outcome. The incidence of the primary outcome was sensitive to the definition of myocardial infarction; a secondary analysis yielded more procedural myocardial infarctions of uncertain clinical importance. There were 145 deaths in the invasive-strategy group and 144 deaths in the conservative-strategy group (hazard ratio, 1.05; 95% CI, 0.83 to 1.32).Conclusions: Among patients with stable coronary disease and moderate or severe ischemia, we did not find evidence that an initial invasive strategy, as compared with an initial conservative strategy, reduced the risk of ischemic cardiovascular events or death from any cause over a median of 3.2 years. The trial findings were sensitive to the definition of myocardial infarction that was used. (Funded by the National Heart, Lung, and Blood Institute and others; ISCHEMIA ClinicalTrials.gov number, .) Patients with stable coronary disease were randomly assigned to an initial invasive strategy with angiography and revascularization if appropriate or to medical therapy alone. At 3.2 years, there was no significant difference between the groups with respect to the estimated rate of ischemic events. The findings were sensitive to the definition of myocardial infarction. | |
650 | 7 | a MEDICIN OCH HÄLSOVETENSKAPx Klinisk medicinx Kardiologi0 (SwePub)302062 hsv//swe |
650 | 7 | a MEDICAL AND HEALTH SCIENCESx Clinical Medicinex Cardiac and Cardiovascular Systems0 (SwePub)302062 hsv//eng |
700 | 1 | a Hochman, Judith S.u NYU, Grossman Sch Med, New York, NY USA.4 aut |
700 | 1 | a Reynolds, Harmony R.u NYU, Grossman Sch Med, New York, NY USA.4 aut |
700 | 1 | a Bangalore, Sripalu NYU, Grossman Sch Med, New York, NY USA.4 aut |
700 | 1 | a O'Brien, Sean M.u Duke Clin Res Inst, Durham, NC USA.4 aut |
700 | 1 | a Boden, William E.u Vet Affairs VA New England Healthcare Syst, Boston, MA USA.;Boston Univ, Sch Med, Boston, MA 02118 USA.4 aut |
700 | 1 | a Chaitman, Bernard R.u St Louis Univ, Sch Med, St Louis, MO 63103 USA.4 aut |
700 | 1 | a Senior, Roxyu Northwick Pk Hosp & Clin Res Ctr, London, England.;Imperial Coll London, London, England.;Royal Brompton Hosp, London, England.4 aut |
700 | 1 | a Lopez-Sendon, Joseu Hosp Univ La Paz, Inst Invest La Paz, Ctr Invest Biomed Red Cardiovasc, Madrid, Spain.4 aut |
700 | 1 | a Alexander, Karen P.u Duke Clin Res Inst, Durham, NC USA.4 aut |
700 | 1 | a Lopes, Renato D.u Duke Clin Res Inst, Durham, NC USA.4 aut |
700 | 1 | a Shaw, Leslee J.u Weill Cornell Med New York Presbyterian Hosp, New York, NY USA.4 aut |
700 | 1 | a Berger, Jeffrey S.u NYU, Grossman Sch Med, New York, NY USA.4 aut |
700 | 1 | a Newman, Jonathan D.u NYU, Grossman Sch Med, New York, NY USA.4 aut |
700 | 1 | a Sidhu, Mandeep S.u Albany Med Coll, Albany, NY 12208 USA.;Albany Med Ctr, Albany, NY USA.4 aut |
700 | 1 | a Goodman, Shaun G.u Univ Toronto, Canadian Heart Res Ctr, Toronto, ON, Canada.;Univ Toronto, St Michaels Hosp, Toronto, ON, Canada.4 aut |
700 | 1 | a Ruzyllo, Witoldu Natl Inst Cardiol, Warsaw, Poland.4 aut |
700 | 1 | a Gosselin, Gilbertu Montreal Heart Inst, Res Ctr, Montreal, PQ, Canada.4 aut |
700 | 1 | a Maggioni, Aldo P.u Assoc Nazl Med Cardiol Osped, Florence, Italy.4 aut |
700 | 1 | a White, Harvey D.u Auckland Hosp Green Lane Cardiovasc Serv, Auckland, New Zealand.4 aut |
700 | 1 | a Bhargava, Balramu All India Inst Med Sci, New Delhi, India.4 aut |
700 | 1 | a Min, James K.u Cleerly, New York, NY USA.4 aut |
700 | 1 | a Mancini, G. B. Johnu Univ British Columbia, Vancouver, BC, Canada.4 aut |
700 | 1 | a Berman, Daniel S.u Cedars Sinai Med Ctr, Los Angeles, CA 90048 USA.4 aut |
700 | 1 | a Picard, Michael H.u Massachusetts Gen Hosp, Boston, MA 02114 USA.;Harvard Med Sch, Boston, MA 02115 USA.4 aut |
700 | 1 | a Kwong, Raymond Y.u Brigham & Womens Hosp, 75 Francis St, Boston, MA 02115 USA.4 aut |
700 | 1 | a Ali, Ziad A.u Cardiovasc Res Fdn, New York, NY USA.;Columbia Univ, Irving Med Ctr, New York Presbyterian Hosp, New York, NY USA.;St Francis Hosp, Roslyn, NY USA.4 aut |
700 | 1 | a Mark, Daniel B.u Duke Clin Res Inst, Durham, NC USA.4 aut |
700 | 1 | a Spertus, John A.u St Lukes Mid Amer Heart Inst, Kansas City, MO USA.;Univ Missouri, Sch Med, Kansas City, MO 64108 USA.4 aut |
700 | 1 | a Krishnan, Mangalath N.u Govt Med Coll Kozhikode, Kozhikode, Kerala, India.4 aut |
700 | 1 | a Elghamaz, Ahmedu Northwick Pk Hosp & Clin Res Ctr, London, England.4 aut |
700 | 1 | a Moorthy, Nagarajau Sri Jayadeva Inst Cardiovasc Sci & Res, Bangalore, Karnataka, India.4 aut |
700 | 1 | a Hueb, Whady A.u Univ Sao Paulo, Hosp Clin, Fac Med, Inst Coracao, Sao Paulo, Brazil.4 aut |
700 | 1 | a Demkow, Marcinu Natl Inst Cardiol, Dept Coronary & Struct Heart Dis, Warsaw, Poland.;Natl Inst Cardiol, Warsaw, Poland.4 aut |
700 | 1 | a Mavromatis, Kretonu Emory Univ, Sch Med, Atlanta VA Med Ctr, Decatur, GA 30033 USA.4 aut |
700 | 1 | a Bockeria, Olgau Natl Res Ctr Cardiovasc Surg, Moscow, Russia.4 aut |
700 | 1 | a Peteiro, Jesusu Complejo Hosp Univ A Coruna, Ctr Invest Biomed Red Cardiovasc, La Coruna, Spain.4 aut |
700 | 1 | a Miller, Todd D.u Mayo Clin, Rochester, MN USA.4 aut |
700 | 1 | a Szwed, Hannau Natl Inst Cardiol, Warsaw, Poland.4 aut |
700 | 1 | a Doerr, Rolfu Praxisklin Herz & Gefaesse, Dresden, Germany.4 aut |
700 | 1 | a Keltai, Matyasu Semmelweis Univ, Budapest, Hungary.4 aut |
700 | 1 | a Selvanayagam, Joseph B.u Flinders Univ S Australia, Flinders Med Ctr, Adelaide, SA, Australia.4 aut |
700 | 1 | a Steg, P. Gabrielu Univ Paris, AP HP, Paris, France.;INSERM, U1148, Paris, France.4 aut |
700 | 1 | a Held, Claes,d 1956-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),Kardiologi4 aut0 (Swepub:uu)clahe947 |
700 | 1 | a Kohsaka, Shunu Keio Univ, Sch Med, Shinjuku Ku, Tokyo, Japan.4 aut |
700 | 1 | a Mavromichalis, Stavroulau NYU, Grossman Sch Med, New York, NY USA.4 aut |
700 | 1 | a Kirby, Ruthu NIH, Bldg 10, Bethesda, MD 20892 USA.4 aut |
700 | 1 | a Jeffries, Neal O.u NIH, Bldg 10, Bethesda, MD 20892 USA.4 aut |
700 | 1 | a Harrell, Frank E., Jr.u Vanderbilt Univ, Sch Med, Nashville, TN 37212 USA.4 aut |
700 | 1 | a Rockhold, Frank W.u Duke Clin Res Inst, Durham, NC USA.4 aut |
700 | 1 | a Broderick, Samuelu Duke Clin Res Inst, Durham, NC USA.4 aut |
700 | 1 | a Ferguson, T. Bruce, Jr.u East Carolina Univ, Brody Sch Med, Greenville, NC 27858 USA.4 aut |
700 | 1 | a Williams, David O.u Brigham & Womens Hosp, 75 Francis St, Boston, MA 02115 USA.4 aut |
700 | 1 | a Harrington, Robert A.u Stanford Univ, Sch Med, Dept Med, 1265 Welch Rd,Med Sch Off Bldg x314, Stanford, CA 94305 USA.4 aut |
700 | 1 | a Stone, Gregg W.u Cardiovasc Res Fdn, New York, NY USA.;Icahn Sch Med Mt Sinai, New York, NY 10029 USA.4 aut |
700 | 1 | a Rosenberg, Yvesu NIH, Bldg 10, Bethesda, MD 20892 USA.4 aut |
700 | 1 | a Eggers, Kai M.,d 1962-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),ISCHEMIA Research Group0 (Swepub:uu)kaieg561 |
700 | 1 | a Johnston, Nina,d 1961-u Uppsala universitet,Uppsala kliniska forskningscentrum (UCR),ISCHEMIA Research Group0 (Swepub:uu)ninjo389 |
700 | 1 | a Soveri, Ingau Uppsala universitet,Njurmedicin,ISCHEMIA Research Group0 (Swepub:uu)insov254 |
710 | 2 | a Stanford Univ, Sch Med, Dept Med, 1265 Welch Rd,Med Sch Off Bldg x314, Stanford, CA 94305 USA.b NYU, Grossman Sch Med, New York, NY USA.4 org |
773 | 0 | t New England Journal of Medicineg 382:15, s. 1395-1407q 382:15<1395-1407x 0028-4793x 1533-4406 |
856 | 4 8 | u https://urn.kb.se/resolve?urn=urn:nbn:se:uu:diva-411466 |
856 | 4 8 | u https://doi.org/10.1056/NEJMoa1915922 |
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