| Factors influencing clinical outcomes after revascularization in the asymptomatic cardiac ischemia pilot (ACIP). ACIP Study Group. | |
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MedLine Citation:
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PMID: 10678439 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND AND AIM: The Asymptomatic Cardiac Ischemia Pilot is the first randomized trial where revascularization involved choice of either coronary bypass or angioplasty used in an early or a delayed symptom-driven approach. One-year outcomes were favorable (reduced recurrent ischemia and adverse outcomes) for an early revascularization strategy (within 4 weeks), compared with an early medical strategy when revascularization was delayed until symptom-driven. This ancillary study examined variables influencing outcomes after these 2 revascularization approaches (early vs. delayed until symptom-driven). METHODS: Participants were clinically stable coronary disease patients with stress-induced and daily life ischemia who underwent revascularization. Characteristics associated with clinical outcomes occurring within the year following revascularization were examined using Cox regression analysis. RESULTS: A total of 262 patients received revascularization; 170 in the early approach and 92 in the delayed symptom-driven approach. Thirty-three patients had adverse outcomes (death, nonfatal myocardial infarction, or repeat revascularization) during 1-year follow-up. The most important independent predictor of improved outcome during the follow-up year was attempted revascularization of > or = 66% of vessels with significant stenosis for the early (risk ratio [RR] 0.25, 95% confidence interval [CI] 0.09-0.67) and the delayed (RR 0.21, CI 0.08-0.58) approaches. Factors such as age, stress test results, and coronary angiographic findings did not predict clinical outcome. CONCLUSIONS: Our findings are important in the planning of a large trial with longer follow-up. |
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Authors:
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C J Pepine; M G Bourassa; B R Chaitman; R F Davies; R A Kerensky; B Sharaf; G L Knatterud; S A Forman; C M Pratt; E D Staples; G Sopko; C R Conti |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S. |
Journal Detail:
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Title: Journal of cardiac surgery Volume: 14 ISSN: 0886-0440 ISO Abbreviation: J Card Surg Publication Date: 1999 Jan-Feb |
Date Detail:
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Created Date: 2000-03-16 Completed Date: 2000-03-16 Revised Date: 2007-11-14 |
Medline Journal Info:
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Nlm Unique ID: 8908809 Medline TA: J Card Surg Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1-8 Citation Subset: IM |
Affiliation:
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University of Florida, College of Medicine, Division of Cardiovascular Medicine, Gainesville 32610-0277, USA. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Adult Aged Angioplasty, Transluminal, Percutaneous Coronary* Coronary Artery Bypass* Female Follow-Up Studies Humans Male Middle Aged Myocardial Infarction / diagnosis, mortality, therapy* Myocardial Ischemia / diagnosis, mortality, therapy* Pilot Projects Regression Analysis Retreatment Survival Rate Time Factors Treatment Outcome |
| Grant Support | |
ID/Acronym/Agency:
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HV-90-07/HV/NHLBI NIH HHS; HV-90-08/HV/NHLBI NIH HHS; HV-91-05/HV/NHLBI NIH HHS |
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