Key result
In patients with acute coronary syndromes and residual ischaemia, revascularisation did not reduce the risk of death compared to no revascularisation (7% vs 6%, p=0.68).
Why the study?
Does revascularisation for residual ischaemia reduce mortality in patients with ACS treated with coronary stenting?
Cohort (n=598)
Does revascularisation for residual ischaemia reduce mortality in patients with ACS treated with coronary stenting?
Absolute Event Rate: 7% vs 6%
p-value: p=0.68
Revascularisation for residual ischaemia detected by stress CMR early after ACS and stenting does not appear to confer a survival benefit compared to medical management.
Results The 598 patients (age 59 ± 12 years, 20% female underwent stress CMR a median of 93 days (IQR: 41, 224 days) after coronary stenting with follow-up for 1.4 years (IQR: 0.6-2.7). Inducible perfusion defects were identified in 294 (49%) patients of whom 18 (6%) died during follow-up compared with 6 (2.0%) patients with no perfusion defects (p = 0.01). Of the 294 patients with perfusion defects, 70 (24%) were revascularised (PCI 55, CABG 27) of whom 5 (7%) died during follow-up compared with 13 (6%) who were not revascularised(p = 0.68). K-M survival analysis confirmed that revascularisation was unassociated with survival benefit, regardless of the severity of ischaemia (Figure 1).
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Sekhri et al. (2016) conducted a cohort in Acute coronary syndromes (n=598). Revascularisation vs. No revascularisation was evaluated on Death during follow-up (p=0.68). In patients with acute coronary syndromes and residual ischaemia, revascularisation did not reduce the risk of death compared to no revascularisation (7% vs 6%, p=0.68).
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