| Coronary revascularization (surgical or percutaneous) decreases mortality after the first year in diabetic subjects but not in nondiabetic subjects with multivessel disease: an analysis from the Medicine, Angioplasty, or Surgery Study (MASS II). | |
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MedLine Citation:
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PMID: 16820611 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: It is currently unknown whether revascularization procedures are associated with an improvement in mortality among diabetic subjects, as compared with a more conservative medical treatment. METHODS AND RESULTS: In MASS II, a total of 611 patients with stable multivessel coronary disease were randomly assigned to medical treatment, surgery, or angioplasty. From these, 190 patients had diabetes (medical, 75 patients; angioplasty, 56 patients; surgery, 59 patients) and comprised the present study population. Mortality rates were analyzed for the entire 5 years of follow-up. Separate analyzes were also performed for mortality at 2 time intervals: during the first year and after the first year of follow-up. We calculated the probability of death conditional on surviving to the start of the interval analyzed. The cumulative 5-year mortality as well as the mortality during the first year of follow-up was not significantly different among treatment groups, both for diabetic and for nondiabetic subjects. Also, during years 2 to 5, the mortality of the 3 treatment groups was not different for nondiabetic subjects. Among diabetic subjects, however, patients randomized to angioplasty or surgery had a significantly lower mortality between years 2 and 5 than those allocated to medical treatment (P=0.039). CONCLUSIONS: Surgery, angioplasty, and medical treatment appear to be associated with similar mortality rates for non-diabetic subjects. For diabetic subjects, however, coronary revascularization (percutaneous or surgical) significantly decreased the risk of death after the first year and up to 5 years, compared with medical treatment alone. |
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Authors:
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Paulo R Soares; Whady A Hueb; Pedro A Lemos; Neuza Lopes; Eulógio E Martinez; Luis A M Cesar; Sergio A Oliveira; Jose A F Ramires |
Publication Detail:
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Type: Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Circulation Volume: 114 ISSN: 1524-4539 ISO Abbreviation: Circulation Publication Date: 2006 Jul |
Date Detail:
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Created Date: 2006-07-05 Completed Date: 2006-08-18 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 0147763 Medline TA: Circulation Country: United States |
Other Details:
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Languages: eng Pagination: I420-4 Citation Subset: AIM; IM |
Affiliation:
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Heart Institute, University of Sao Paulo Medical School, Av. Dr. Enéas de Carvalho Aguiar, 44 sala 114, Sao Paulo-SP 05403-000, Brazil. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Adrenergic beta-Antagonists
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therapeutic use Aged Angioplasty, Balloon, Laser-Assisted / statistics & numerical data Angioplasty, Transluminal, Percutaneous Coronary* / statistics & numerical data Angiotensin-Converting Enzyme Inhibitors / therapeutic use Antihypertensive Agents / therapeutic use Aspirin / therapeutic use Coronary Artery Bypass* / statistics & numerical data Coronary Disease / complications, drug therapy, pathology, surgery* Diabetes Complications / mortality, surgery* Diabetes Mellitus, Type 1 / complications Diabetes Mellitus, Type 2 / complications Female Follow-Up Studies Humans Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use Hypercholesterolemia / complications, diet therapy, drug therapy Hypoglycemic Agents / therapeutic use Life Tables Male Middle Aged Proportional Hazards Models Prospective Studies Retrospective Studies Risk Stents Survival Analysis Treatment Outcome |
| Chemical | |
Reg. No./Substance:
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0/Adrenergic beta-Antagonists; 0/Angiotensin-Converting Enzyme Inhibitors; 0/Antihypertensive Agents; 0/Hydroxymethylglutaryl-CoA Reductase Inhibitors; 0/Hypoglycemic Agents; 50-78-2/Aspirin |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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