Clinical outcomes in patients with stable coronary artery disease with vs. without a history of myocardial revascularization

Aims: The aim was to describe outcomes among patients with stable coronary artery disease (CAD) with or without a history of myocardial revascularization in a large contemporary cohort. Methods and results: Patients with stable CAD were selected from the Reduction of Atherothrombosis for Continued H...

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Main Authors: Elbez, Y., Cheong, A., Fassa, A., Cohen, E., Reid, Christopher, Babarskiene, R., Bhatt, D., Steg, P.
Format: Journal Article
Published: 2016
Online Access:http://hdl.handle.net/20.500.11937/73630
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author Elbez, Y.
Cheong, A.
Fassa, A.
Cohen, E.
Reid, Christopher
Babarskiene, R.
Bhatt, D.
Steg, P.
author_facet Elbez, Y.
Cheong, A.
Fassa, A.
Cohen, E.
Reid, Christopher
Babarskiene, R.
Bhatt, D.
Steg, P.
author_sort Elbez, Y.
building Curtin Institutional Repository
collection Online Access
description Aims: The aim was to describe outcomes among patients with stable coronary artery disease (CAD) with or without a history of myocardial revascularization in a large contemporary cohort. Methods and results: Patients with stable CAD were selected from the Reduction of Atherothrombosis for Continued Health (REACH) registry. The cohort was divided into patients with (n = 25 583) and without (n = 13 133) a history of myocardial revascularization. Crude outcomes were described according to the use and type of revascularization: percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG). The primary outcome was cardiovascular (CV) death. At baseline, the non-revascularized group was older and had more CV risk factors. At 36-month median followup, previous revascularization was associated with a lower risk of CV death [crude incidence rate (CIR): 6.82 vs. 9.08%, hazard ratio (HR) 0.73 [95% confidence interval (CI) 0.66.0.80]; P < 0.01]. This association was seen for patients with a history of PCI (CIR 5.78 vs. 8.88%, HR 0.64 [0.58.0.71]; P = 0.01), but not with CABG (HR 1.26 [1.14.1.49]; P < 0.01), and was consistent regardless of prior MI and the timing of prior revascularization. Conclusion: Among patients with stable CAD, a history of myocardial revascularization was associated with lower CV mortality, particularly when PCI was the mode of revascularization. Coronary artery disease patients managed non-invasively represent a high-risk group.
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spelling curtin-20.500.11937-736302019-07-16T03:50:49Z Clinical outcomes in patients with stable coronary artery disease with vs. without a history of myocardial revascularization Elbez, Y. Cheong, A. Fassa, A. Cohen, E. Reid, Christopher Babarskiene, R. Bhatt, D. Steg, P. Aims: The aim was to describe outcomes among patients with stable coronary artery disease (CAD) with or without a history of myocardial revascularization in a large contemporary cohort. Methods and results: Patients with stable CAD were selected from the Reduction of Atherothrombosis for Continued Health (REACH) registry. The cohort was divided into patients with (n = 25 583) and without (n = 13 133) a history of myocardial revascularization. Crude outcomes were described according to the use and type of revascularization: percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG). The primary outcome was cardiovascular (CV) death. At baseline, the non-revascularized group was older and had more CV risk factors. At 36-month median followup, previous revascularization was associated with a lower risk of CV death [crude incidence rate (CIR): 6.82 vs. 9.08%, hazard ratio (HR) 0.73 [95% confidence interval (CI) 0.66.0.80]; P < 0.01]. This association was seen for patients with a history of PCI (CIR 5.78 vs. 8.88%, HR 0.64 [0.58.0.71]; P = 0.01), but not with CABG (HR 1.26 [1.14.1.49]; P < 0.01), and was consistent regardless of prior MI and the timing of prior revascularization. Conclusion: Among patients with stable CAD, a history of myocardial revascularization was associated with lower CV mortality, particularly when PCI was the mode of revascularization. Coronary artery disease patients managed non-invasively represent a high-risk group. 2016 Journal Article http://hdl.handle.net/20.500.11937/73630 10.1093/ehjqcco/qcv017 restricted
spellingShingle Elbez, Y.
Cheong, A.
Fassa, A.
Cohen, E.
Reid, Christopher
Babarskiene, R.
Bhatt, D.
Steg, P.
Clinical outcomes in patients with stable coronary artery disease with vs. without a history of myocardial revascularization
title Clinical outcomes in patients with stable coronary artery disease with vs. without a history of myocardial revascularization
title_full Clinical outcomes in patients with stable coronary artery disease with vs. without a history of myocardial revascularization
title_fullStr Clinical outcomes in patients with stable coronary artery disease with vs. without a history of myocardial revascularization
title_full_unstemmed Clinical outcomes in patients with stable coronary artery disease with vs. without a history of myocardial revascularization
title_short Clinical outcomes in patients with stable coronary artery disease with vs. without a history of myocardial revascularization
title_sort clinical outcomes in patients with stable coronary artery disease with vs. without a history of myocardial revascularization
url http://hdl.handle.net/20.500.11937/73630