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Five-year follow-up of angiographic disease progression after medicine, angioplasty, or surgery

BACKGROUND: Progression of atherosclerosis in coronary artery disease is observed through consecutive angiograms. Prognosis of this progression in patients randomized to different treatments has not been established. This study compared progression of coronary artery disease in native coronary arter...

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Autores principales: Borges, Jorge Chiquie, Lopes, Neuza, Soares, Paulo R, Góis, Aécio FT, Stolf, Noedir A, Oliveira, Sergio A, Hueb, Whady A, Ramires, Jose AF
Formato: Texto
Lenguaje:English
Publicado: BioMed Central 2010
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987924/
https://www.ncbi.nlm.nih.gov/pubmed/20977758
http://dx.doi.org/10.1186/1749-8090-5-91
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author Borges, Jorge Chiquie
Lopes, Neuza
Soares, Paulo R
Góis, Aécio FT
Stolf, Noedir A
Oliveira, Sergio A
Hueb, Whady A
Ramires, Jose AF
author_facet Borges, Jorge Chiquie
Lopes, Neuza
Soares, Paulo R
Góis, Aécio FT
Stolf, Noedir A
Oliveira, Sergio A
Hueb, Whady A
Ramires, Jose AF
author_sort Borges, Jorge Chiquie
collection PubMed
description BACKGROUND: Progression of atherosclerosis in coronary artery disease is observed through consecutive angiograms. Prognosis of this progression in patients randomized to different treatments has not been established. This study compared progression of coronary artery disease in native coronary arteries in patients undergoing surgery, angioplasty, or medical treatment. METHODS: Patients (611) with stable multivessel coronary artery disease and preserved ventricular function were randomly assigned to CABG, PCI, or medical treatment alone (MT). After 5-year follow-up, 392 patients (64%) underwent new angiography. Progression was considered a new stenosis of ≥ 50% in an arterial segment previously considered normal or an increased grade of previous stenosis > 20% in nontreated vessels. RESULTS: Of the 392 patients, 136 underwent CABG, 146 PCI, and 110 MT. Baseline characteristics were similar among treatment groups, except for more smokers and statin users in the MT group, more hypertensives and lower LDL-cholesterol levels in the CABG group, and more angina in the PCI group at study entry. Analysis showed greater progression in at least one native vessel in PCI patients (84%) compared with CABG (57%) and MT (74%) patients (p < 0.001). LAD coronary territory had higher progression compared with LCX and RCA (P < 0.001). PCI treatment, hypertension, male sex, and previous MI were independent risk factors for progression. No statistical difference existed between coronary events and the development of progression. CONCLUSION: The angioplasty treatment conferred greater progression in native coronary arteries, especially in the left anterior descending territories and treated vessels. The progression was independently associated with hypertension, male sex, and previous myocardial infarction.
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spelling pubmed-29879242010-11-19 Five-year follow-up of angiographic disease progression after medicine, angioplasty, or surgery Borges, Jorge Chiquie Lopes, Neuza Soares, Paulo R Góis, Aécio FT Stolf, Noedir A Oliveira, Sergio A Hueb, Whady A Ramires, Jose AF J Cardiothorac Surg Research Article BACKGROUND: Progression of atherosclerosis in coronary artery disease is observed through consecutive angiograms. Prognosis of this progression in patients randomized to different treatments has not been established. This study compared progression of coronary artery disease in native coronary arteries in patients undergoing surgery, angioplasty, or medical treatment. METHODS: Patients (611) with stable multivessel coronary artery disease and preserved ventricular function were randomly assigned to CABG, PCI, or medical treatment alone (MT). After 5-year follow-up, 392 patients (64%) underwent new angiography. Progression was considered a new stenosis of ≥ 50% in an arterial segment previously considered normal or an increased grade of previous stenosis > 20% in nontreated vessels. RESULTS: Of the 392 patients, 136 underwent CABG, 146 PCI, and 110 MT. Baseline characteristics were similar among treatment groups, except for more smokers and statin users in the MT group, more hypertensives and lower LDL-cholesterol levels in the CABG group, and more angina in the PCI group at study entry. Analysis showed greater progression in at least one native vessel in PCI patients (84%) compared with CABG (57%) and MT (74%) patients (p < 0.001). LAD coronary territory had higher progression compared with LCX and RCA (P < 0.001). PCI treatment, hypertension, male sex, and previous MI were independent risk factors for progression. No statistical difference existed between coronary events and the development of progression. CONCLUSION: The angioplasty treatment conferred greater progression in native coronary arteries, especially in the left anterior descending territories and treated vessels. The progression was independently associated with hypertension, male sex, and previous myocardial infarction. BioMed Central 2010-10-26 /pmc/articles/PMC2987924/ /pubmed/20977758 http://dx.doi.org/10.1186/1749-8090-5-91 Text en Copyright ©2010 Borges et al; licensee BioMed Central Ltd. http://creativecommons.org/licenses/by/2.0 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Research Article
Borges, Jorge Chiquie
Lopes, Neuza
Soares, Paulo R
Góis, Aécio FT
Stolf, Noedir A
Oliveira, Sergio A
Hueb, Whady A
Ramires, Jose AF
Five-year follow-up of angiographic disease progression after medicine, angioplasty, or surgery
title Five-year follow-up of angiographic disease progression after medicine, angioplasty, or surgery
title_full Five-year follow-up of angiographic disease progression after medicine, angioplasty, or surgery
title_fullStr Five-year follow-up of angiographic disease progression after medicine, angioplasty, or surgery
title_full_unstemmed Five-year follow-up of angiographic disease progression after medicine, angioplasty, or surgery
title_short Five-year follow-up of angiographic disease progression after medicine, angioplasty, or surgery
title_sort five-year follow-up of angiographic disease progression after medicine, angioplasty, or surgery
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2987924/
https://www.ncbi.nlm.nih.gov/pubmed/20977758
http://dx.doi.org/10.1186/1749-8090-5-91
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