Document Detail


Factors influencing clinical outcomes after revascularization in the asymptomatic cardiac ischemia pilot (ACIP). ACIP Study Group.
MedLine Citation:
PMID:  10678439     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
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:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Journal of cardiac surgery     Volume:  14     ISSN:  0886-0440     ISO Abbreviation:  J Card Surg     Publication Date:    1999 Jan-Feb
Date Detail:
Created Date:  2000-03-16     Completed Date:  2000-03-16     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8908809     Medline TA:  J Card Surg     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1-8     Citation Subset:  IM    
Affiliation:
University of Florida, College of Medicine, Division of Cardiovascular Medicine, Gainesville 32610-0277, USA.
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MeSH Terms
Descriptor/Qualifier:
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:
HV-90-07/HV/NHLBI NIH HHS; HV-90-08/HV/NHLBI NIH HHS; HV-91-05/HV/NHLBI NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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