Accès ouvert déclaré
2022
article
Survival After Invasive or Conservative Management of Stable Coronary Disease
Judith S. Hochman, Rebecca Anthopolos, Harmony R. Reynolds, Sripal Bangalore, Yifan Xu, Sean M. O’Brien, Stavroula Mavromichalis, Michelle Chang, Aira Contreras, Yves Rosenberg, Ruth Kirby, Balram Bhargava, Roxy Senior, Ann Banfield, Shaun G. Goodman, Renato D. Lópes, Radosław Pracoń, José López‐Sendón, Aldo P. Maggioni, Jonathan Newman, Jeffrey S. Berger, Mandeep S. Sidhu, Harvey D. White, Andrea B. Troxel, Robert A. Harrington, William E. Boden, Gregg W. Stone, Daniel B. Mark, John A. Spertus, David J. Maron, Shari Esquenazi‐Karonika, Margaret Gilsenan, Ewelina Gwiszcz, Patenne D. Mathews, Samaa Mohamed, Anna K. Naumova, Arline Roberts, Kerrie VanLoo, Ying Lü, Zhen Huang, Samuel Broderick, Luis A. Guzmán, Joseph B. Selvanayagam, Jean‐Michel Juliard, Rolf Doerr, Mátyás Keltai, Balram Bhargava, Boban Thomas, Tali Sharir, Eugenia Nikolsky, Shun Kohsaka, Jorge Escobedo, O.L. Bockeria, Claes Held, Leslee J. Shaw, Lawrence M. Phillips, Daniel S. Berman, Raymond Y. Kwong, Michael H. Picard, Bernard Chaitman, Ziad A. Ali, James K. Min, G.B. John Mancini, Jonathon Leipsic, Graham S. Hillis, S. Thambar, Majo Joseph, John F. Beltrame, Iréne Lang, Herwig Schuchlenz, Kurt Huber, Kaatje Goetschalckx, Whady Hueb, Paulo Caramori, Alexandre de Quadros, Paola Smanio, Cláudio Tinoco Mesquita, João V. Vítola, José Antônio Marin‐Neto, Rogério Tumelero, Alvaro Rabelo Alves, Frederico Dall’Orto, Carísi Anne Polanczyk, Estêvão Lanna Figueiredo, Andrew Howarth, Gilbert Gosselin, Asim N. Cheema, Kevin R. Bainey, Denis Phaneuf, Ariel Díaz, Pallav Garg, Shamir Mehta, Graham C. Wong, Andy Lam, James Cha, Paul Galiwango, Amar Uxa, Benjamin J.W. Chow, Adnan Hameed, Jacob A. Udell, Marie Hauguel‐Moreau, Alain Furber, Pascal Goube, Philippe Gabríel Steg, Gilles Barone‐Rochette, Christophe Thuaire, Michel Slama, Georg Nickenig, Raffi Bekeredjian, P. Christian Schulze, Béla Merkely, Géza Fontos, András Vértes, Albert Varga, Ajit Kumar, Rajesh Gopalan Nair, Purvez Grant, Cholenahally Nanjappa Manjunath, Nagaraja Moorthy, Santhosh Satheesh, Ranjit Kumar Nath, Gurpreet Singh Wander, Johann Christopher, Sudhanshu Kumar Dwivedi, Abraham Oomman, Atul Mathur, Milind Gadkari, Sudhir Naik, Eapen Punnoose, Ranjan Kachru, Upendra Kaul, Arthur Kerner, Giuseppe Tarantini, Gian Piero Perna, Emanuela Racca, Andrea Mortara, Lorenzo Monti, Carlo Briguori, Gianpiero Leone, Roberto Amati, Mauro Salvatori, Antonio Di Chiara, Paolo Calabrò, Marcello Galvani, Stefano Provasoli, Keiichi Fukuda, Shintaro Nakano, Aleksandras Laucevičius, Saško Kedev, Ahmad Khairuddin, Robert K. Riezebos, Jorik R. Timmer, S. Heald, Ralph Stewart, Walter Mogrovejo Ramos, Marcin Demkow, Tomasz Mazurek, Hanna Szwed, Adam Witkowski, Nuno Ferreira, Fausto J. Pinto, Rúben Ramos, Bogdan A. Popescu, Călin Pop, L.A. Bockeriа, Е. А. Демченко, Alexander Romanov, Л. Л. Берштейн, Ahmed Al Jizeeri, Goran Stanković, Svetlana Apostolović, Nada Čemerlić Adjić, Marija Zdravković, Branko Beleslin, Milica Dekleva, Goran Davidović, Terrance Chua, David Foo, Kian Keong Poh, Mpiko Ntsekhe, Alessandro Sionís, Francisco Marı́n, Vicente Miró, Montserrat Gracida Blancas, José Ramón González‐Juanatey, Francisco Fernández‐Avilés, Jesús Peteiro, Jose Enrique Castillo Luena, Johannes Aspberg, Mariagrazia Rossi, Srun Kuanprasert, Sukit Yamwong, Nicola Johnston, Patrick Donnelly, Andrew Moriarty, Ahmed Elghamaz, Sothinathan Gurunathan, Nikolaos Karogiannis, Benoy N. Shah, Richard Trimlett, Michael B. Rubens, Edward Nicol, Tarun Mittal, Reinette Hampson, Reto Gamma, Mark de Belder, Thuraia Nageh, Steven Lindsay, Kreton Mavromatis, Todd D. Miller, Subhash Banerjee, Khaled Nour, Peter Stone
153Citations signalées — pas une note de qualité
26Institutions déclarées
9Pays d’affiliation déclarés
Résumé fourni par la source
BACKGROUND: The ISCHEMIA trial (International Study of Comparative Health Effectiveness With Medical and Invasive Approaches) compared an initial invasive versus an initial conservative management strategy for patients with chronic coronary disease and moderate or severe ischemia, with no major difference in most outcomes during a median of 3.2 years. Extended follow-up for mortality is ongoing. METHODS: ISCHEMIA participants were randomized to an initial invasive strategy added to guideline-directed medical therapy or a conservative strategy. Patients with moderate or severe ischemia, ejection fraction ≥35%, and no recent acute coronary syndromes were included. Those with an unacceptable level of angina were excluded. Extended follow-up for vital status is being conducted by sites or through central death index search. Data obtained through December 2021 are included in this interim report. We analyzed all-cause, cardiovascular, and noncardiovascular mortality by randomized strategy, using nonparametric cumulative incidence estimators, Cox regression models, and Bayesian methods. Undetermined deaths were classified as cardiovascular as prespecified in the trial protocol. RESULTS: Baseline characteristics for 5179 original ISCHEMIA trial participants included median age 65 years, 23% women, 16% Hispanic, 4% Black, 42% with diabetes, and median ejection fraction 0.60. A total of 557 deaths accrued during a median follow-up of 5.7 years, with 268 of these added in the extended follow-up phase. This included a total of 343 cardiovascular deaths, 192 noncardiovascular deaths, and 22 unclassified deaths. All-cause mortality was not different between randomized treatment groups (7-year rate, 12.7% in invasive strategy, 13.4% in conservative strategy; adjusted hazard ratio, 1.00 [95% CI, 0.85-1.18]). There was a lower 7-year rate cardiovascular mortality (6.4% versus 8.6%; adjusted hazard ratio, 0.78 [95% CI, 0.63-0.96]) with an initial invasive strategy but a higher 7-year rate of noncardiovascular mortality (5.6% versus 4.4%; adjusted hazard ratio, 1.44 [95% CI, 1.08-1.91]) compared with the conservative strategy. No heterogeneity of treatment effect was evident in prespecified subgroups, including multivessel coronary disease. CONCLUSIONS: There was no difference in all-cause mortality with an initial invasive strategy compared with an initial conservative strategy, but there was lower risk of cardiovascular mortality and higher risk of noncardiovascular mortality with an initial invasive strategy during a median follow-up of 5.7 years. REGISTRATION: URL: https://www. CLINICALTRIALS: gov; Unique identifier: NCT04894877.
Ce résumé expose les affirmations des auteurs. BNTIC ne l’interprète pas comme une validation indépendante des résultats.
Contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- Survival After Invasive or Conservative Management of Stable Coronary Disease
- Date Crossref
- 03/01/2023
- Éditeur
- Ovid Technologies (Wolters Kluwer Health)
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude et ne compte pas comme une seconde source scientifique indépendante.
Institutions déclarées
Une affiliation ne permet pas de déduire la nationalité d’un auteur.
Sujets associés
Cardiac Imaging and DiagnosticsAcute Myocardial Infarction ResearchCoronary Interventions and Diagnostics