Long-term Survival in Patients Undergoing Percutaneous Interventions With or Without Intracoronary Pressure Wire Guidance or Intracoronary Ultrasonographic Imaging

Fröhlich, Georg; Redwood, Simon; Rakhit, Roby; MacCarthy, Philip; Lim, Pitt; Crake, Tom; White, Steven K; Knight, Charles; Kustosz, Christoph P.; Knapp, Guido; Dalby, Miles; Mali, Iqbal S.; Archbold, R. Andrew; Wragg, Andrew; Timmis, Adam; Meier, Pascal

doi:10.1001/jamainternmed.2014.1595

Cited by 43 publications

(39 citation statements)

References 28 publications

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“…23,24 Similarly, there was little use during the trial enrollment period of coronary intra-vascular ultrasonography or other new coronary imaging methods that have prognostic significance. 25,26 Finally, it must be acknowledged that certain baseline clinical and demographic characteristics, such as the low percentage of women (15%) and the sizable minority of veterans (42%) enrolled in the original trial, could have played a role in the findings we report.…”

Section: Discussionmentioning

confidence: 90%

Effect of PCI on Long-Term Survival in Patients with Stable Ischemic Heart Disease

Act¹,

et al. 2015

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BACKGROUND Percutaneous coronary intervention (PCI) relieves angina in patients with stable ischemic heart disease, but clinical trials have not shown that it improves survival. Between June 1999 and January 2004, we randomly assigned 2287 patients with stable ischemic heart disease to an initial management strategy of optimal medical therapy alone (medical-therapy group) or optimal medical therapy plus PCI (PCI group) and did not find a significant difference in the rate of survival during a median follow-up of 4.6 years. We now report the rate of survival among the patients who were followed for up to 15 years. METHODS We obtained permission from the patients at the Department of Veterans Affairs (VA) sites and some non-VA sites in the United States to use their Social Security numbers to track their survival after the original trial period ended. We searched the VA national Corporate Data Warehouse and the National Death Index for survival information and the dates of death from any cause. We calculated survival according to the Kaplan–Meier method and used a Cox proportional-hazards model to adjust for significant between-group differences in baseline characteristics. RESULTS Extended survival information was available for 1211 patients (53% of the original population). The median duration of follow-up for all patients was 6.2 years (range, 0 to 15); the median duration of follow-up for patients at the sites that permitted survival tracking was 11.9 years (range, 0 to 15). A total of 561 deaths (180 during the follow-up period in the original trial and 381 during the extended follow-up period) occurred: 284 deaths (25%) in the PCI group and 277 (24%) in the medical-therapy group (adjusted hazard ratio, 1.03; 95% confidence interval, 0.83 to 1.21; P = 0.76). CONCLUSIONS During an extended-follow-up of up to 15 years, we did not find a difference in survival between an initial strategy of PCI plus medical therapy and medical therapy alone in patients with stable ischemic heart disease. (Funded by the VA Cooperative Studies Program and others; COURAGE ClinicalTrials.gov number, NCT00007657.)

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Section: Discussionmentioning

confidence: 90%

Effect of PCI on Long-Term Survival in Patients with Stable Ischemic Heart Disease

Act¹,

et al. 2015

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“…The numbers of events in each study were extracted when available. Table depicts patients' baseline characteristics, demographics, studies type and type of target lesions and clinical settings of each study .…”

Section: Methodsmentioning

confidence: 99%

Fractional flow reserve versus angiography guided percutaneous coronary intervention: An updated systematic review

Enezate

Omran

Al-Dadah

et al. 2017

Cathet Cardio Intervent

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“…After reviewing the full texts of the remaining 26 articles, 19 were excluded and the reasons for exclusion are shown in Figure 1A. A total of seven articles were included in the meta-analysis [8,11,[15][16][17][18][19]. Abbreviations: RCT = randomized controlled trials; CAD = coronary artery diseases; PCI = percutaneous coronary intervention; FFR = fractional flow reserve; and, Angio = angiography.…”

Section: Literature Searchmentioning

confidence: 99%

Comparing treatment outcomes of fractional flow reserve-guided and angiography-guided percutaneous coronary intervention in patients with multi-vessel coronary artery diseases: a systematic review and meta-analysis

Xiu¹,

Chen²,

Zheng³

et al. 2016

CIM

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*Contributed equally to this work.Comparing treatment outcomes of fractional flow reserve-guided and angiography-guided percutaneous coronary intervention in patients with multi-vessel coronary artery diseases: a systematic review and meta-analysis Methods: Prospective and retrospective studies comparing FFR-guided vs. angiography-guided PCI in patients with multi-vessel CAD were identified from medical databases by two independent reviewers using the terms "percutaneous coronary intervention, fractional flow reserve, angiography, coronary heart disease, major adverse cardiac events (MACE) and myocardial infarction". The primary outcome was the number of stents placed, and the secondary outcomes were procedure time, mortality, myocardial infarction (MI) and MACE rates.Results: Seven studies (three retrospective and four prospective), which included 49,517 patients, were included in this review. A total of 4,755 patients underwent FFR, while 44,697 received angiography-guided PCI. The mean patient age ranged from 58 to 71.7 years. The average number of stents used in FFR patients ranged from 0.3-1.9, and in angiography-guided PCI patients ranged from 0.7-2.7. Analysis indicated there was a greater number of stents placed in the angiography-guided group compared with the FFR group (pooled difference in means: -0.64, 95% confidence interval [CI]: -0.81 to -0.47, P < 0.001). There were no differences in the secondary outcomes between the two groups.Conclusions: Both procedures produce similar clinical outcomes, but the fewer number of stents used with FFR may have clinical as was as cost implications.

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Long-term Survival in Patients Undergoing Percutaneous Interventions With or Without Intracoronary Pressure Wire Guidance or Intracoronary Ultrasonographic Imaging

Cited by 43 publications

References 28 publications

Effect of PCI on Long-Term Survival in Patients with Stable Ischemic Heart Disease

Effect of PCI on Long-Term Survival in Patients with Stable Ischemic Heart Disease

Fractional flow reserve versus angiography guided percutaneous coronary intervention: An updated systematic review

Comparing treatment outcomes of fractional flow reserve-guided and angiography-guided percutaneous coronary intervention in patients with multi-vessel coronary artery diseases: a systematic review and meta-analysis

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