Repository logo
 
Publication

Coronary Revascularization vs. Medical Therapy Following Coronary-Computed Tomographic Angiography in Patients with Low-, Intermediate- and High-Risk Coronary Artery Disease: Results From the CONFIRM Long-Term Registry

2017-05-01Journal article Open access
Simple item page
dc.contributor.authorSchulman-Marcus, Joshua
dc.contributor.authorLin, Fay Y
dc.contributor.authorGransar, Heidi
dc.contributor.authorBerman, Daniel
dc.contributor.authorCallister, Tracy
dc.contributor.authorDeLago, Augustin
dc.contributor.authorHadamitzky, Martin
dc.contributor.authorHausleiter, Joerg
dc.contributor.authorAl-Mallah, Mouaz
dc.contributor.authorBudoff, Matthew
dc.contributor.authorKaufmann, Philipp
dc.contributor.authorAchenbach, Stephan
dc.contributor.authorRaff, Gilbert
dc.contributor.authorChinnaiyan, Kavitha
dc.contributor.authorCademartiri, Filippo
dc.contributor.authorMaffei, Erica
dc.contributor.authorVillines, Todd
dc.contributor.authorKim, Yong-Jin
dc.contributor.authorLeipsic, Jonathon
dc.contributor.authorFeuchtner, Gudrun
dc.contributor.authorRubinshtein, Ronen
dc.contributor.authorPontone, Gianluca
dc.contributor.authorAndreini, Daniele
dc.contributor.authorPinto Marques, H
dc.contributor.authorChang, Hyuk-Jae
dc.contributor.authorChow, Benjamin J W
dc.contributor.authorCury, Ricardo C
dc.contributor.authorDunning, Allison
dc.contributor.authorShaw, Leslee
dc.contributor.authorMin, James K
dc.date.accessioned2019-03-12T16:15:12Z
dc.date.available2019-03-12T16:15:12Z
dc.date.issued2017-05-01
dc.description.abstractAIMS: To identify the effect of early revascularization on 5-year survival in patients with CAD diagnosed by coronary-computed tomographic angiography (CCTA). METHODS AND RESULTS: We examined 5544 stable patients with suspected CAD undergoing CCTA who were followed a median of 5.5 years in a large international registry. Patients were categorized as having low-, intermediate-, or high-risk CAD based on CCTA findings. Two treatment groups were defined: early revascularization within 90 days of CCTA (n = 1171) and medical therapy (n = 4373). To account for the non-randomized referral to revascularization, we developed a propensity score by logistic regression. This score was incorporated into Cox proportional hazard models to calculate the effect of revascularization on all-cause mortality. Death occurred in 363 (6.6%) patients and was more frequent in medical therapy. In multivariable models, when compared with medical therapy, the mortality benefit of revascularization varied significantly over time and by CAD risk (P for interaction 0.04). In high-risk CAD, revascularization was significantly associated with lower mortality at 1 year (hazard ratio [HR] 0.22, 95% confidence interval [CI] 0.11-0.47) and 5 years (HR 0.31, 95% CI 0.18-0.54). For intermediate-risk CAD, revascularization was associated with reduced mortality at 1 year (HR 0.45, 95% CI 0.22-0.93) but not 5 years (HR 0.63, 95% CI 0.33-1.20). For low-risk CAD, there was no survival benefit at either time point. CONCLUSIONS: Early revascularization was associated with reduced 1-year mortality in intermediate- and high-risk CAD detected by CCTA, but this association only persisted for 5-year mortality in high-risk CAD.pt_PT
dc.description.versioninfo:eu-repo/semantics/publishedVersionpt_PT
dc.identifier.citationEur Heart J Cardiovasc Imaging. 2017 May 1;18(8):841-848.pt_PT
dc.identifier.doi10.1093/ehjci/jew287pt_PT
dc.identifier.urihttp://hdl.handle.net/10400.17/3181
dc.language.isoengpt_PT
dc.peerreviewedyespt_PT
dc.publisherEuropean Society of Cardiologypt_PT
dc.subjectAge Factorspt_PT
dc.subjectAgedpt_PT
dc.subjectAnalysis of Variancept_PT
dc.subjectCardiotonic Agentspt_PT
dc.subjectCause of Deathpt_PT
dc.subjectComputed Tomography Angiographypt_PT
dc.subjectCoronary Angiographypt_PT
dc.subjectCoronary Artery Diseasept_PT
dc.subjectFemalept_PT
dc.subjectHumanspt_PT
dc.subjectInternationalitypt_PT
dc.subjectKaplan-Meier Estimatept_PT
dc.subjectMalept_PT
dc.subjectMiddle Agedpt_PT
dc.subjectMultivariate Analysispt_PT
dc.subjectMyocardial Revascularizationpt_PT
dc.subjectOdds Ratiopt_PT
dc.subjectPercutaneous Coronary Interventionpt_PT
dc.subjectPrognosispt_PT
dc.subjectProportional Hazards Modelspt_PT
dc.subjectRisk Assessmentpt_PT
dc.subjectSeverity of Illness Indexpt_PT
dc.subjectSex Factorspt_PT
dc.subjectSurvival Analysispt_PT
dc.subjectTreatment Outcomept_PT
dc.subjectRegistriespt_PT
dc.subjectHCC CIRpt_PT
dc.titleCoronary Revascularization vs. Medical Therapy Following Coronary-Computed Tomographic Angiography in Patients with Low-, Intermediate- and High-Risk Coronary Artery Disease: Results From the CONFIRM Long-Term Registrypt_PT
dc.typejournal article
dspace.entity.typePublication
oaire.citation.endPage848pt_PT
oaire.citation.issue8pt_PT
oaire.citation.startPage841pt_PT
oaire.citation.titleEHJ Cardiovascular Imaging / European Heart Journal - Cardiovascular Imagingpt_PT
oaire.citation.volume18pt_PT
rcaap.rightsopenAccesspt_PT
rcaap.typearticlept_PT

Files

Original bundle
Now showing 1 - 1 of 1
Thumbnail Image
Name:
Eur Heart J Cardiovasc Imag 2017 841.pdf
Size:
266.68 KB
Format:
Adobe Portable Document Format
Download
License bundle
Now showing 1 - 1 of 1
No Thumbnail Available
Name:
license.txt
Size:
1.71 KB
Format:
Item-specific license agreed upon to submission
Description:
Download

Collections

CIR - Artigos