Document Detail


The effect of coronary artery bypass grafting on specific causes of long-term mortality in the Bypass Angioplasty Revascularization Investigation.
MedLine Citation:
PMID:  17599484     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVES: We sought to examine the effect of revascularization with coronary artery bypass grafting on specific causes of death in the Bypass Angioplasty Revascularization Investigation cohort. Although the effect of coronary revascularization on long-term mortality has been previously described, there are limited data describing its effect on specific causes of death in patients with coronary artery disease. Evaluation of cause of death might help elucidate disease mechanisms and be useful for developing treatment strategies. METHODS: In the Bypass Angioplasty Revascularization Investigation randomized trial and registry, 3610 patients underwent initial revascularization with coronary artery bypass grafting or balloon angioplasty and were followed for an average of 7.7 years. Causes of all deaths were classified by an independent committee. RESULTS: Among 3610 revascularized patients, 2239 underwent coronary artery bypass grafting as an initial or subsequent procedure. Over 7.7 years of follow-up, 3% of all patients died of sudden cardiac death, 3% died of myocardial infarction-related death, 2% died of congestive heart failure and other cardiac causes, and 9% died of noncardiac causes. Coronary artery bypass grafting (vs no coronary artery bypass grafting) was associated with a significantly lower risk of sudden cardiac death (relative risk, 0.60; P = .01) but was not significantly associated with any other causes of long-term mortality. CONCLUSIONS: In the Bypass Angioplasty Revascularization Investigation coronary artery bypass grafting significantly decreased the risk of sudden cardiac death but not any other cause of long-term mortality. Because major risk factors for sudden cardiac death have historically favored a revascularization strategy of coronary artery bypass grafting over angioplasty, evaluation of the current practice of extending angioplasty as an alternative to coronary artery bypass grafting in similar high-risk subgroups is paramount.
Authors:
David R Holmes; Lauren J Kim; Maria Mori Brooks; Kevin E Kip; Hartzell V Schaff; Katherine M Detre; Robert L Frye;
Related Documents :
23478134 - Contribution of sympathetic activation to coronary vasodilatation during the cold press...
9754464 - Alteration of the traditional extracorporeal bypass circuit to accommodate port-access ...
7376074 - Atheromatous changes in expanded polytetrafluoroethylene grafts.
313194 - Anesthetic considerations for aortocoronary bypass graft surgery.
7585754 - Normal post-race antimyosin myocardial scintigraphy in asymptomatic marathon runners wi...
15582314 - Prophylactic implantable cardioverter-defibrillator therapy in patients with left ventr...
Publication Detail:
Type:  Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, N.I.H., Extramural    
Journal Detail:
Title:  The Journal of thoracic and cardiovascular surgery     Volume:  134     ISSN:  1097-685X     ISO Abbreviation:  J. Thorac. Cardiovasc. Surg.     Publication Date:  2007 Jul 
Date Detail:
Created Date:  2007-06-29     Completed Date:  2007-07-24     Revised Date:  2007-12-03    
Medline Journal Info:
Nlm Unique ID:  0376343     Medline TA:  J Thorac Cardiovasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  38-46, 46.e1     Citation Subset:  AIM; IM    
Affiliation:
Division of Cardiovascular Diseases and Internal Medicine, Mayo Clinic College of Medicine, Rochester, Minn, USA.
Export Citation:
APA/MLA Format     Download EndNote     Download BibTex
MeSH Terms
Descriptor/Qualifier:
Aged
Angioplasty, Transluminal, Percutaneous Coronary
Cardiovascular Diseases / mortality
Cause of Death*
Coronary Artery Bypass / mortality*
Coronary Disease / mortality,  surgery
Death, Sudden, Cardiac / epidemiology
Female
Follow-Up Studies
Humans
Male
Middle Aged
Multivariate Analysis
Myocardial Revascularization / mortality*
Registries
Retrospective Studies
Risk Assessment
Survival Analysis
Survival Rate
Grant Support
ID/Acronym/Agency:
HL38493/HL/NHLBI NIH HHS; HL38504/HL/NHLBI NIH HHS; HL38509/HL/NHLBI NIH HHS; HL38512/HL/NHLBI NIH HHS; HL38514-6/HL/NHLBI NIH HHS; HL38518/HL/NHLBI NIH HHS; HL38524-5/HL/NHLBI NIH HHS; HL38529/HL/NHLBI NIH HHS; HL38532/HL/NHLBI NIH HHS; HL38556/HL/NHLBI NIH HHS; HL38610/HL/NHLBI NIH HHS; HL38642/HL/NHLBI NIH HHS; HL42145/HL/NHLBI NIH HHS

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


Previous Document:  Strict glycemic control reduces EuroSCORE expected mortality in diabetic patients undergoing myocard...
Next Document:  Single-stage repair of arch aneurysms with a long elephant trunk: medium-term follow-up of thromboex...