Document Detail


Staged Versus One-time Complete Revascularization With Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease Patients Without ST-Elevation Myocardial Infarction.
MedLine Citation:
PMID:  23322743     Owner:  NLM     Status:  Publisher    
Abstract/OtherAbstract:
BACKGROUND: THERE ARE EVIDENCE-BASED GUIDELINES FOR STAGING OF PATIENTS WITH ST-ELEVATION MYOCARDIAL INFARCTION (STEMI) UNDERGOING PERCUTANEOUS CORONARY INTERVENTION (PCI), BUT WE ARE NOT AWARE OF ANY EVIDENCE COMPARING THE STRATEGY OF COMPLETE REVASCULARIZATION (CR) WITH PCI IN THE INDEX ADMISSION VERSUS THE STRATEGY OF STAGING IN A SUBSEQUENT ADMISSION FOR PATIENTS WITH CORONARY ARTERY DISEASE WITHOUT STEMI.METHODS AND RESULTS: PCI PATIENTS WITHOUT STEMI UNDERGOING PCI IN NEW YORK BETWEEN 2007 AND 2009 WERE SEPARATED INTO 2 GROUPS: THOSE WITH ACUTE CORONARY SYNDROME BUT NO STEMI, AND THOSE WITHOUT ACUTE CORONARY SYNDROME. FOR EACH GROUP, PATIENTS WHO UNDERWENT CR IN THE INDEX ADMISSION WERE THEN PROPENSITY MATCHED TO PATIENTS STAGED WITHIN 60 DAYS TO OBTAIN CR BASED ON 17 PATIENT RISK FACTORS RELATED TO LONGER-TERM MORTALITY, AND 3-YEAR MORTALITY RATES WERE COMPARED FOR THE PROPENSITY-MATCHED GROUPS. OUTCOMES WERE ALSO COMPARED FOR PRESELECTED SUBGROUPS. FOR PROPENSITY-MATCHED PATIENTS WITHOUT ACUTE CORONARY SYNDROME, THE ALL-CAUSE MORTALITY RATES AT 3 YEARS FOR PATIENTS WHO UNDERWENT CR IN THE INDEX HOSPITALIZATION AND PATIENTS STAGED FOR CR WITHIN 60 DAYS OF DISCHARGE WERE 5.62% AND 5.97%, P=0.93, RESPECTIVELY. FOR PROPENSITY-MATCHED PATIENTS WITH ACUTE CORONARY SYNDROME BUT WITHOUT STEMI, THE ALL-CAUSE MORTALITY RATES AT 3 YEARS FOR PATIENTS WHO UNDERWENT CR IN THE INDEX HOSPITALIZATION AND PATIENTS STAGED FOR CR WITHIN 60 DAYS OF DISCHARGE WERE 6.59% AND 5.92%, P=0.41, RESPECTIVELY.CONCLUSIONS: Patients with coronary artery disease without STEMI do not have significantly lower 3-year mortality rates with staged PCI than when they undergo CR in the index admission.
Authors:
Edward L Hannan; Zaza Samadashvili; Gary Walford; Alice K Jacobs; Nicholas J Stamato; Ferdinand J Venditti; David R Holmes; Samin Sharma; Spencer B King
Related Documents :
24176063 - Prognostic utility of the syntax score in patients with single versus multivessel disea...
23071773 - Relation between mild to moderate chronic kidney disease and coronary artery disease de...
21791363 - Evaluation of resynchronization therapy for heart failure in patients with a qrs durati...
Publication Detail:
Type:  JOURNAL ARTICLE     Date:  2013-1-15
Journal Detail:
Title:  Circulation. Cardiovascular interventions     Volume:  -     ISSN:  1941-7632     ISO Abbreviation:  Circ Cardiovasc Interv     Publication Date:  2013 Jan 
Date Detail:
Created Date:  2013-1-16     Completed Date:  -     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  101499602     Medline TA:  Circ Cardiovasc Interv     Country:  -    
Other Details:
Languages:  ENG     Pagination:  -     Citation Subset:  -    
Affiliation:
University at Albany, State University of New York, Albany, NY.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:

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


Previous Document:  Acute Effects of Embolizing Systemic-to-Pulmonary Arterial Collaterals on Blood Flow in Patients Wit...
Next Document:  Superior vena cava stenting in the 21st century.