What question did this study set out to answer?

To compare baseline characteristics and one-year clinical outcomes among patients with multivessel coronary artery disease undergoing complete revascularization versus targeted revascularization.

August 23, 2007Journal of Interventional Cardiology

Completeness of Revascularization for Multivessel Coronary Artery Disease and Its Effect on One‐Year Outcome: A Report from the NHLBI Dynamic Registry

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Why the study?

Does targeted revascularization compared to complete revascularization affect 1-year outcomes in patients with multivessel coronary disease undergoing PCI?

Population

1,781 patients with multivessel coronary disease undergoing percutaneous coronary intervention from the…

Comparison

Targeted revascularization. vs Complete revascularization (CR) (n=315).

Design

Cohort

Follow-up

1 year

Authors

VSVankeepuram SrinivasGandhi Medical College & Hospital FSFaith SelzerBoston University RWRobert L. WilenskyInterventional Cardiology

Discussion

Member takes

Implication

Targeted revascularization was associated with similar 1-year outcomes; leaves open whether randomized trials would confirm equivalence in multivessel disease.

Key Points

To compare baseline characteristics and one-year clinical outcomes among patients with multivessel coronary artery disease undergoing complete revascularization versus targeted revascularization.
Evaluated patients from the NHLBI Dynamic Registry undergoing targeted revascularization by operator choice (n = 1,091), targeted revascularization due to unachievable complete revascularization (n = 375), and complete revascularization (n = 315).
Compared cumulative one-year mortality, repeat percutaneous coronary intervention, and coronary bypass surgery using multivariable models adjusted for baseline clinical characteristics and propensity scores.
Adjusted risk for one-year mortality did not differ significantly between complete and targeted revascularization (HR 1.10, 95% CI: 0.58–2.10).
Risk of repeat percutaneous coronary intervention (HR 0.89, 95% CI: 0.60–1.32) and composite repeat revascularization with bypass surgery (HR 0.92, 95% CI: 0.66–1.29) were equivalent between groups at one year.

Structured PICO

Does targeted revascularization compared to complete revascularization affect 1-year outcomes in patients with multivessel coronary disease undergoing PCI?

Population

1,781 patients with multivessel coronary disease undergoing percutaneous coronary intervention (PCI) from the NHLBI Dynamic Registry.

Intervention

Targeted revascularization (TR) (performed either by operator choice [n=1,091] or because complete revascularization was unachievable [n=375]).

Comparator

Complete revascularization (CR) (n=315).

Outcome

Cumulative rates of 1-year mortality, the need for repeat PCI, or coronary bypass surgery.hard clinical

In patients with multivessel coronary disease undergoing PCI, targeted revascularization demonstrates equivalent 1-year outcomes to complete revascularization, supporting its continued use in selected patients.

Cite This Study

Srinivas et al. (2007) studied this question.

synapsesocial.com/papers/6a81f03dd433ecbb06e1ebf6 https://doi.org/10.1111/j.1540-8183.2007.00273.x

Topics

Coronary artery disease Coronary CT angiography

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Implication

Targeted revascularization was associated with similar 1-year outcomes; leaves open whether randomized trials would confirm equivalence in multivessel disease.

Completeness of Revascularization for Multivessel Coronary Artery Disease and Its Effect on One‐Year Outcome: A Report from the NHLBI Dynamic Registry

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Topics

Completeness of Revascularization for Multivessel Coronary Artery Disease and Its Effect on One‐Year Outcome: A Report from the NHLBI Dynamic Registry

Discussion

Member takes

Implication

Key Points

Structured PICO

Cite This Study

Also Consider

Topics

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