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Assessing the association of appropriateness of coronary revascularization and 1-year clinical outcomes for patients with stable coronary artery disease in China

التفاصيل البيبلوغرافية
العنوان: Assessing the association of appropriateness of coronary revascularization and 1-year clinical outcomes for patients with stable coronary artery disease in China
المؤلفون: Shen Lin, Heng Zhang, Chen-Fei Rao, Si-Peng Chen, Shu-Bin Qiao, Hong-Bing Yan, Ke-Fei Dou, Yong-Jian Wu, Yi-Da Tang, Xin-Chun Yang, Zhu-Jun Shen, Jian Liu, Zhe Zheng, Ning-Ning Wang, Beijing Coronary Angiography Registry Collaborative Group
المصدر: Chinese Medical Journal, Vol 133, Iss 1, Pp 1-8 (2020)
بيانات النشر: Wolters Kluwer, 2020.
سنة النشر: 2020
المجموعة: LCC:Medicine
مصطلحات موضوعية: Medicine
الوصف: Abstract. Background:. The Chinese appropriate use criteria (AUC) for coronary revascularization was released in 2016 to improve the use of coronary revascularization. This study aimed to evaluate the association between the appropriateness of coronary revascularization based on the Chinese AUC and 1-year outcomes in stable coronary artery disease (CAD) patients. Methods. : We conducted a prospective, multi-center cohort study of stable CAD patients with coronary lesion stenosis ≥50%. After the classification of appropriateness based on Chinese AUC, patients were categorized into the coronary revascularization group or the medical therapy group based on treatment received. The primary outcome was a composite of death, myocardial infarction, stroke, repeated revascularization, and ischemic symptoms with hospital admission. Results:. From August 2016 to August 2017, 6085 patients were consecutively enrolled. Coronary revascularization was associated with a lower adjusted hazard of 1-year major adverse cardiovascular and cerebrovascular events (MACCEs; hazard ratio [HR]: 0.62; 95% confidence interval [CI]: 0.45–0.86; P = 0.004) than medical therapy in patients with appropriate indications (n = 1617). No significant benefit in 1-year MACCEs was found after revascularization compared to after medical therapy in patients with uncertain indications (n = 2658, HR: 0.81; 95% CI: 0.52–1.25; P = 0.338) and inappropriate indications (n = 1810, HR: 0.80; 95% CI: 0.51–1.23; P = 0.308). Conclusions:. In patients with appropriate indications according to Chinese AUC, coronary revascularization was associated with significantly lower risk of MACCEs at 1 year. No benefit was found in coronary revascularization in patients with inappropriate indications. Our findings provide evidence for using Chinese AUC to guide clinical decision-making. Clinical trial registration:. NCT02880605. https://www.clinicaltrials.gov.
نوع الوثيقة: article
وصف الملف: electronic resource
اللغة: English
تدمد: 0366-6999
2542-5641
00000000
Relation: http://journals.lww.com/10.1097/CM9.0000000000000592; https://doaj.org/toc/0366-6999; https://doaj.org/toc/2542-5641
DOI: 10.1097/CM9.0000000000000592
URL الوصول: https://doaj.org/article/5ca7cf9521334384b8b66ed1087338e3
رقم الأكسشن: edsdoj.5ca7cf9521334384b8b66ed1087338e3
قاعدة البيانات: Directory of Open Access Journals
الوصف
تدمد:03666999
25425641
00000000
DOI:10.1097/CM9.0000000000000592