| Quantitative results of baseline angiography and percutaneous coronary intervention in the COURAGE trial. | |
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MedLine Citation:
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PMID: 20031857 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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BACKGROUND: COURAGE compared outcomes in stable coronary patients randomized to optimal medical therapy plus percutaneous coronary intervention (PCI) versus optimal medical therapy alone. METHODS AND RESULTS: Angiographic data were analyzed by treatment arm, health care system (Veterans Administration, US non-Veterans Administration, Canada), and gender. Veterans Administration patients had higher prevalence of coronary artery bypass graft surgery and left ventricular ejection fraction < or =50%. Men had worse diameter stenosis of the most severe lesion, higher prevalence of prior coronary artery bypass graft surgery, lower left ventricular ejection fraction, and more 3-vessel disease that included a proximal left anterior descending lesion (P<0.0001 for all comparisons versus women). Failure to cross rate (3%) and visual angiographic success of stent procedures (97%) were similar to contemporary practice in the National Cardiovascular Data Registry. Quantitative angiographic PCI success was 93% (residual lesion <50% in-segment) and 82% (<20% in-stent), with only minor nonsignificant differences among health care systems and genders. Event rates were higher in patients with higher jeopardy scores and more severe vessel disease, but rates were similar irrespective of treatment strategy. Within the PCI plus optimal medical therapy arm, complete revascularization was associated with a trend toward lower rate of death or nonfatal myocardial infarction. Complete revascularization was similar between genders and among health care systems. CONCLUSIONS: PCI success and completeness of revascularization did not differ significantly by health care system or gender and were similar to contemporary practice. Angiographic burden of disease affected overall event rates but not response to an initial strategy of PCI plus optimal medical therapy or optimal medical therapy alone. |
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Authors:
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G B John Mancini; Eric R Bates; David J Maron; Pamela Hartigan; Marcin Dada; Gilbert Gosselin; William Kostuk; Steven P Sedlis; Leslee J Shaw; Daniel S Berman; Peter B Berger; John Spertus; Kreton Mavromatis; Merril Knudtson; Bernard R Chaitman; Robert A O'Rourke; William S Weintraub; Koon Teo; William E Boden; |
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Publication Detail:
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Type: Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, Non-P.H.S. Date: 2009-06-02 |
Journal Detail:
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Title: Circulation. Cardiovascular quality and outcomes Volume: 2 ISSN: 1941-7705 ISO Abbreviation: Circ Cardiovasc Qual Outcomes Publication Date: 2009 Jul |
Date Detail:
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Created Date: 2009-12-24 Completed Date: 2010-03-26 Revised Date: - |
Medline Journal Info:
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Nlm Unique ID: 101489148 Medline TA: Circ Cardiovasc Qual Outcomes Country: United States |
Other Details:
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Languages: eng Pagination: 320-7 Citation Subset: IM |
Affiliation:
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Vancouver Hospital, Cardiovascular Imaging Research Core Laboratory, University of British Columbia, Vancouver, Canada. mancini@interchange.ubc.ca |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angina Pectoris
/
mortality,
radiography,
therapy Angioplasty, Transluminal, Percutaneous Coronary / mortality* Canada / epidemiology Cardiovascular Agents / therapeutic use* Coronary Angiography / mortality* Coronary Stenosis* / mortality, radiography, therapy Female Humans Male Morbidity Myocardial Infarction / mortality, radiography, therapy Outcome Assessment (Health Care) Prevalence Severity of Illness Index Sex Distribution Stents / statistics & numerical data* United States / epidemiology |
| Grant Support | |
ID/Acronym/Agency:
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//Canadian Institutes of Health Research |
| Chemical | |
Reg. No./Substance:
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0/Cardiovascular Agents |
| Comments/Corrections | |
Comment In:
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Circ Cardiovasc Qual Outcomes. 2009 Jul;2(4):292-3
[PMID:
20031852
]
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From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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