Does prior coronary angioplasty affect outcomes of surgical coronary revascularization? Insights from the STICH trial

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art_NICOLAU_Does_prior_coronary_angioplasty_affect_outcomes_of_surgical_2019.PDF (579.14 KB)
Citações na Scopus
3
Tipo de produção
article
Data de publicação
2019
DOI
Scopus
Web of Science
PubMed
Título da Revista
ISSN da Revista
Título do Volume
Editora
ELSEVIER IRELAND LTD
Autores
STEVENS, Susanna R.
AL-KHALIDI, Hussein R.
DESVIGNE-NICKENS, Patrice
HADDAD, Haissam
JOLICOEUR, E. Marc
Citação
INTERNATIONAL JOURNAL OF CARDIOLOGY, v.291, p.36-41, 2019
Projetos de Pesquisa
Unidades Organizacionais
Fascículo
Resumo
Background: The STICH trial showed superiority of coronary artery bypass plus medical treatment (CABG) over medical treatment alone (MED) in patients with left ventricular ejection fraction (LVEF) <= 35%. In previous publications, percutaneous coronary intervention (PCI) prior to CABG was associated with worse prognosis. Objectives: The main purpose of this study was to analyse if prior PCI influenced outcomes in STICH. Methods and results: Patients in the STICH trial (n=1212), followed for a median time of 9.8 years, were included in the present analyses. In the total population, 156 had a prior PCI (74 and 82, respectively, in the MED and CABG groups). In those with vs. without prior PCI, the adjusted hazard-ratios (aHRs) were 0.92 (95% CI=0.74-1.15) for all-cause mortality, 0.85 (95% CI=0.64-1.11) for CV mortality, and 1.43 (95% CI=1.15-1.77) for CV hospitalization. In the group randomized to CABG without prior PCI, the aHRs were 0.82 (95% CI=0.70-0.95) for all-cause mortality, 0.75 (95% CI=0.62-0.90) for CV mortality and 0.67 (95% CI=0.56-0.80) for CV hospitalization. In the group randomized to CABG with prior PCI, the aHRs were 0.76 (95% CI=0.50-1.15) for all-cause mortality, 0.81 (95% CI=0.49-1.36) for CV mortality and 0.61 (95% CI=0.41-0.90) for CV hospitalization. There was no evidence of interaction between randomized treatment and prior PCI for any endpoint (all adjusted p > 0.05). Conclusion: In the STICH trial, prior PCI did not affect the outcomes of patients whether they were treated medically or surgically, and the superiority of CABG over MED remained unchanged regardless of prior PCI.
Palavras-chave
Coronary artery bypass surgery, Heart failure, Left ventricular dysfunction, Percutaneous coronary intervention
URI
https://observatorio.fm.usp.br/handle/OPI/33029
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Coleções
Artigos e Materiais de Revistas Científicas - FM/MCP
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