Why the study?
Does prophylactic coronary artery revascularization prior to elective vascular surgery reduce long-term mortality in patients with clinically stable coronary artery disease?
Population
510 patients with clinically stable coronary artery disease scheduled for elective abdominal aortic or…
Comparison
Preoperative coronary artery revascularization… vs No revascularization before vascular surgery.
Design
RCT, A randomized design was used to assign 510 patients to a strategy of…
Follow-up
Median 2.7 years
Authors
Discussion
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Member takes
Implication
No long-term mortality benefit from prophylactic revascularization before vascular surgery; confirms medical management as standard for stable CAD.
Structured PICO
Does prophylactic coronary artery revascularization prior to elective vascular surgery reduce long-term mortality in patients with clinically stable coronary artery disease?
P
Population
510 patients (98% men) with clinically stable coronary artery disease scheduled for elective abdominal aortic or infrainguinal vascular surgery, considered at increased risk for perioperative cardiac complications. Excluded: unstable angina, left main coronary artery stenosis >50%, left ventricular ejection fraction <20%, or severe aortic stenosis.
I
Intervention
Preoperative coronary artery revascularization (percutaneous coronary intervention [PCI] or coronary artery bypass grafting [CABG] at the discretion of the study centers) prior to vascular surgery.
C
Comparator
No revascularization before vascular surgery.
O
Outcome
Long-term all-cause mortality.hard clinical
Prophylactic coronary revascularization before elective vascular surgery in patients with stable coronary artery disease does not improve long-term survival or reduce perioperative complications.
Cite This Study
Cinà et al. (2006) studied this question.