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- Title
Factors influencing clinical outcomes after revascularization in the asymptomatic cardiac ischemia pilot (ACIP). ACIP Study Group.
- Authors
Pepine, Carl J.; Bourassa, Martial G.; Chaitman, Bernard R.; Davies, Richard F.; Kerensky, Richard A.; Sharaf, Barry; Knatterud, Genell L.; Forman, Sandra A.; Pratt, Craig M.; Staples, Edward D.; Sopko, George; Conti, C. Richard; Pepine, C J; Bourassa, M G; Chaitman, B R; Davies, R F; Kerensky, R A; Sharaf, B; Knatterud, G L; Forman, S A
- Abstract
<bold>Background and Aim: </bold>The Asymptomatic Cardiac Ischemia Pilot is the first randomized trial where revascularization involved choice of either coronary bypass or angioplasty used in an early or a delayed symptom-driven approach. One-year outcomes were favorable (reduced recurrent ischemia and adverse outcomes) for an early revascularization strategy (within 4 weeks), compared with an early medical strategy when revascularization was delayed until symptom-driven. This ancillary study examined variables influencing outcomes after these 2 revascularization approaches (early vs. delayed until symptom-driven).<bold>Methods: </bold>Participants were clinically stable coronary disease patients with stress-induced and daily life ischemia who underwent revascularization. Characteristics associated with clinical outcomes occurring within the year following revascularization were examined using Cox regression analysis.<bold>Results: </bold>A total of 262 patients received revascularization; 170 in the early approach and 92 in the delayed symptom-driven approach. Thirty-three patients had adverse outcomes (death, nonfatal myocardial infarction, or repeat revascularization) during 1-year follow-up. The most important independent predictor of improved outcome during the follow-up year was attempted revascularization of > or = 66% of vessels with significant stenosis for the early (risk ratio [RR] 0.25, 95% confidence interval [CI] 0.09-0.67) and the delayed (RR 0.21, CI 0.08-0.58) approaches. Factors such as age, stress test results, and coronary angiographic findings did not predict clinical outcome.<bold>Conclusions: </bold>Our findings are important in the planning of a large trial with longer follow-up.
- Publication
Journal of Cardiac Surgery, 1999, Vol 14, Issue 1, p1
- ISSN
0886-0440
- Publication type
journal article
- DOI
10.1111/j.1540-8191.1999.tb00943.x