Long-term survival in 11,661 patients with multivessel coronary artery disease in the era of stenting: A report from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) Investigators

Džavík, Vladimir; Ghali, William A.; Norris, Colleen M.; Mitchell, L.Brent; Koshal, Arvind; Saunders, L. Duncan; Galbraith, P. Diane; Hui, William; Faris, Peter; Knudtson, Merril L.

doi:10.1067/mhj.2001.116072

Cited by 117 publications

(57 citation statements)

References 30 publications

(23 reference statements)

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“…Результаты анализа путем оценки жизнеспособности миокарда в этой подгруппе оказа-лись неубедительными [429]. Наблюдательные исследования по данным реги-стра CASS и мета-анализ 7 рандомизированных исследований, с включением данных в целом для 2649 пациентов, в которых сравнивали КШ с медика-ментозной терапией, показали преимущество хирур-гии в плане выживаемости у пациентов с трехсосуди-стым поражением (или поражением ствола ЛКА), при отсутствии различий у пациентов с одно-или двухсосудистым поражением, за исключением паци-ентов с вовлечением проксимального отдела ПМЖВ + еще одной крупной коронарной артерии [445,[454][455][456][457][458]. В дополнение к этому, эти исследования продемонстрировали более высокую эффективность КШ, чем медикаментозной терапии, в устранении симптомов, принимая во внимание тот факт, что в этих исследованиях методы медикаментозной тера-пии и вторичной профилактики были устаревшими, в сравнении с сегодняшними стандартами.…”

Section: операция в условиях искусственного кровообращения или без неunclassified

2013 Esc Guidelines on the Management of Stable Coronary Artery Disease

Montalescot

Sechtem²,

Achenbach³

et al. 2014

Russ J Cardiol

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Section: операция в условиях искусственного кровообращения или без неunclassified

2013 Esc Guidelines on the Management of Stable Coronary Artery Disease

Montalescot

Sechtem²,

Achenbach³

et al. 2014

Russ J Cardiol

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“…[2][3][4][5][6][7][8] The 19 studies used predefined enrollment criteria and were published in peer-reviewed journals. Two independent reviewers (Y.H.…”

Section: Methodsmentioning

confidence: 99%

“…The study-specific effect attributed to PCI was assumed to arise from a normal distribution with unknown mean and unknown PCI-specific between-study variance. Similarly, for the 7 studies that directly compared CABG surgery with MT, [2][3][4][5][6][7][8] we assumed that the number of deaths in the MT arm was a binomial variable with the log-odds of study-specific MT mortality modeled as the rate for CABG surgery arm plus a study-specific increment for the MT arm. As above, the study-specific MT effect was assumed to arise from a normal distribution with unknown mean and unknown MT-specific between-study variation.…”

Section: Bayesian Meta-analysesmentioning

confidence: 99%

See 1 more Smart Citation

Bayesian Methods Affirm the Use of Percutaneous Coronary Intervention to Improve Survival in Patients With Unprotected Left Main Coronary Artery Disease

Bittl

Jacobs

et al. 2013

Circulation

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Background-Several randomized clinical trials support the use of coronary artery bypass grafting (CABG) for patients with unprotected left main coronary artery disease. Studies suggesting the equivalence of percutaneous coronary intervention (PCI) with CABG for this indication indirectly support the 2011 American College of Cardiology Foundation/American Heart Association Class IIa recommendation for PCI to improve survival in patients with unprotected left main coronary artery disease. We tested whether bayesian approaches uphold the new recommendation. Methods and Results-We performed a bayesian cross-design and network meta-analysis of 12 studies (4 randomized clinical trials and 8 observational studies) comparing CABG with PCI (n=4574 patients) and of 7 studies (2 randomized clinical trials and 5 observational studies) comparing CABG with medical therapy (n=3224 patients). The odds ratios of 1-year mortality after PCI compared with CABG using bayesian cross-design meta-analysis were not different among randomized clinical trials (odds ratio, 0.99; 95% bayesian credible interval, 0.67-1.43), matched cohort studies (odds ratio, 1.10; 95% bayesian credible interval, 0.76-1.73), and other types of cohort studies (odds ratio, 0.93; 95% bayesian credible interval, 0.58-1.35). A network meta-analysis suggested that medical therapy is associated with higher 1-year mortality than the use of PCI for patients with unprotected left main coronary artery disease (odds ratio, 3.22; 95% bayesian credible interval, 1.96-5.30). Conclusions-Bayesian methods support the current guidelines, which were based on traditional statistical methods and have proposed that PCI, like CABG, improves survival for patients with unprotected left main coronary artery disease compared with medical therapy. An integrated approach using both direct and indirect evidence may yield new insights to enhance the translation of clinical trial data into practice.

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“…For stent and DES patients with singlevessel disease, we apply a global pro rata reduction of 26% to all mortality rates, based on a metaanalysis that we carried out of large registry studies and long-term trials reporting mortality for single-and two-vessel disease. Results employed were from the APPROACH registry, 225 BARI trial and registry, 226 supplemented by the NHLBI PTCA registry 227 and a review of seven trials by Yusuf and colleagues. 115 Finally, a modifiable treatment effect parameter is included in the model which allows general adjustment of mortality rates for DES patients if evidence of differential mortality rates becomes available.…”

Section: Mortalitymentioning

confidence: 99%

Coronary artery stents: a rapid systematic review and economic evaluation

Hill¹,

Bagust²,

Bakhai³

et al. 2004

Health Technol Assess

144

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Long-term survival in 11,661 patients with multivessel coronary artery disease in the era of stenting: A report from the Alberta Provincial Project for Outcome Assessment in Coronary Heart Disease (APPROACH) Investigators

Cited by 117 publications

References 30 publications

2013 Esc Guidelines on the Management of Stable Coronary Artery Disease

2013 Esc Guidelines on the Management of Stable Coronary Artery Disease

Bayesian Methods Affirm the Use of Percutaneous Coronary Intervention to Improve Survival in Patients With Unprotected Left Main Coronary Artery Disease

Coronary artery stents: a rapid systematic review and economic evaluation

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