Five-Year Follow-up of the Argentine Randomized Trial of Coronary Angioplasty. With Stenting Versus Coronary Bypass Surgery in Patients With Multiple Vessel Disease (ERACI II)

Rodriguez, A; Balde, Jagruti; Pereira, Carlos Fernández

doi:10.1016/j.accreview.2005.11.071

Cited by 46 publications

(61 citation statements)

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“…The estimated incidence of early and delayed stroke is 2% to 9% after CABG 19 and 0.15% to 0.44% after PCI in the literature. 20 Considering the mechanisms by which stroke may occur, it is not surprising that the risk of early and delayed stroke is increased among those who undergo CABG.…”

Section: Discussionmentioning

confidence: 99%

Late Stroke: Comparison of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Multivessel Disease and Unprotected Left Main Disease

Athappan

Chacko

Patvardhan

et al. 2014

Stroke

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Background and Purpose-Studies have suggested that the early excess risk of stroke in coronary artery bypass grafting (CABG) may be compensated for by a slow but progressive catch-up phenomenon in patients undergoing percutaneous coronary intervention (PCI). We therefore undertook this analysis to compare the temporal stroke risk between PCI and CABG in patients with unprotected left main stenosis and multivessel coronary artery disease. Methods-Studies of PCI versus CABG for unprotected left main stenosis and multivessel disease published between January 1994 (stent era) and July 2013 were identified using an electronic search and reviewed using meta-analytic techniques. Results-We selected 57 reports for the meta-analysis by applying the inclusion and exclusion criteria. The primary search terms used were CABG and PCI. For the Cochrane database the search terms were limited by the term clinical trial. Limiting the search parameters to the English language was applied subsequently. Citations were screened at the title and abstract level and retrieved as full reports if they were clinical studies, compared PCI with CABG, and provided information on the outcome of stroke. The full texts of all potential articles were reviewed in detail. The bibliography of retained studies was used to seek additional relevant studies. Inclusion CriteriaStudies were included if the following criteria applied: (1) comparative trials of CABG versus PCI with stent placement, (2) unprotected left main stenosis of >50% narrowing or multivessel disease, (3) a minimum of 30 patients, and (4) a minimum follow-up of 1 year. When 2 similar studies were reported from the same institution or author, the most recent publication was included in the analysis. Exclusion CriteriaStudies were excluded if any of the following criteria applied: (1) outcome of interest was not clearly reported or was impossible to extract or calculate from the published results, (2) <1-year follow-up, (3) included patients with ST-segment-elevation myocardial infarction, and (4) included patients with percutaneous transluminal coronary angioplasty without stents. Data ExtractionInformation collected included first author, year and journal of publication, study design, inclusion/exclusion criteria, definition of primary and secondary end points, number of subjects included, subjects undergoing PCI and CABG, percentage of drug-eluting stent used, study population demographics, number of diseased vessels, stenting technique, type of CABG (on pump versus off pump), left internal mammary artery graft used (single versus double), follow-up time period, rates of angiographic follow-up, antiplatelet regimen used, and primary and secondary outcomes. There was no disagreement between the 2 reviewers (G.A. and P.C.).

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Section: Discussionmentioning

confidence: 99%

Late Stroke: Comparison of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Multivessel Disease and Unprotected Left Main Disease

Athappan

Chacko

Patvardhan

et al. 2014

Stroke

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“…Also, in large series of clinical randomized trials, the CABG groups showed a lower incidence of repeat revascularization [4,5]. In a meta-analysis of randomized controlled trials of PCI and CABG, CABG has been proven to have lower 5-year mortality, less angina, and fewer revascularization procedures compared with PCI, especially in multivessel disease [10].…”

Section: Commentmentioning

confidence: 99%

“…In large series of randomized trials comparing PCI and CABG, the CABG groups showed a lower incidence of major adverse cardiac and cerebrovascular events (MACCE) and repeated revascularization procedures [4,5]. But most of the patients enrolled in those trials underwent coronary intervention with bare-metal stents or conventional CABG, which is performed with cardiopulmonary bypass.…”

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confidence: 99%

Comparison of Off-pump Coronary Artery Bypass Grafting With Percutaneous Coronary Intervention Versus Drug-Eluting Stents for Three-Vessel Coronary Artery Disease

Youn

Yoo

et al. 2008

The Annals of Thoracic Surgery

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“…Mesmo quando os pacientes foram seguidos por muitos anos, nenhuma diferença foi observada. Contudo, a ICP foi associada a risco significativamente maior para subseqüentes revascularizações [4][5][6][7][8][9][10][11][12][13][14] .…”

Section: Introductionunclassified

Avaliação do custo do implante programado de múltiplos stents em mais de uma intervenção percutânea em pacientes com doença coronária multiarterial

Pedroso¹,

Meireles²,

Filho³

et al. 2007

Rev. Bras. Cardiol. Invasiva

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Background:The Brazilian Public Health System (SUS) establishes that coronary angioplasties with implantation of two stents must not exceed 20% of the total amount of angioplasties performed, resulting in the necessity of staged procedures in the majority of the patients with multivessel coronary disease. The objective of this study was to compare the costs of the staged stent implantation policy, imposed by SUS, with the stent implantation approach considered ideal by the interventional cardiology team, in patients with multivessel coronary disease. Methods: Costs were compared in a consecutive cohort of 100 patients with multivessel disease with indication of complete revascularization by percutaneous coronary intervention. Coronary angiographies had been previously evaluated by the interventional cardiology team that had individualized the approach considered ideal for the treatment of each patient. Procedures were then performed in accordance to SUS multistage policy and the costs of the two treatment strategies were compared. Of note, a single stent implantation procedure costs R$4,298.00 according to the SUS price list. Results: Mean age was 61.5±10.7 years, 66% were male, 43% diabetics and 67% had stable angina. Agreement in relation to the SUS staged procedures occurred in 44% and discordance in 56%. An excess of 58 procedures was detected, generating an additional cost of R$131,298.00. Conclusions: The multistaged approach imposed by SUS increases the number of procedures for coronary stent

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Five-Year Follow-up of the Argentine Randomized Trial of Coronary Angioplasty. With Stenting Versus Coronary Bypass Surgery in Patients With Multiple Vessel Disease (ERACI II)

Cited by 46 publications

References 0 publications

Late Stroke: Comparison of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Multivessel Disease and Unprotected Left Main Disease

Late Stroke: Comparison of Percutaneous Coronary Intervention Versus Coronary Artery Bypass Grafting in Patients With Multivessel Disease and Unprotected Left Main Disease

Comparison of Off-pump Coronary Artery Bypass Grafting With Percutaneous Coronary Intervention Versus Drug-Eluting Stents for Three-Vessel Coronary Artery Disease

Avaliação do custo do implante programado de múltiplos stents em mais de uma intervenção percutânea em pacientes com doença coronária multiarterial

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