Coronary Artery Disease, Multivessel Coronary Artery Disease, Myocardial Ischemia, Stable Coronary Artery Disease
Conditions
Keywords
Coronary artery bypass grafting, Percutaneous coronary intervention, Medical therapy, Stable coronary artery disease, Multivessel disease, Vessel-related outcomes, Myocardial infarction, Cardiac death, MASS study
Brief summary
This retrospective cohort study evaluates cardiovascular events directly related to treated coronary arteries in patients with stable multivessel coronary artery disease. Outcomes in patients undergoing coronary artery bypass grafting or percutaneous coronary intervention will be compared with those receiving optimized medical therapy alone. This study aims to improve understanding of how different treatment strategies impact long-term vessel-related outcomes in patients with stable multivessel coronary artery disease.
Detailed description
Previous studies evaluating coronary revascularization strategies have relied on broad composite endpoints, which may include events unrelated to the treated vessel. This study focuses on vessel-related outcomes, specifically non-fatal myocardial infarction and cardiac death attributable to the treated coronary artery. Patients were selected from the MASS (Medicine, Angioplasty, or Surgery Study) database at a single tertiary center. By analyzing vessel-specific events, this study aims to provide a more accurate assessment of the long-term impact of different treatment strategies in stable multivessel coronary artery disease.
Interventions
PROCEDURECoronary Artery Bypass Grafting
Surgical myocardial revascularization using coronary artery bypass grafting.
PROCEDUREPercutaneous Coronary Intervention
Percutaneous coronary intervention performed according to standard clinical practice.
Guideline-directed medical therapy for stable coronary artery disease.
Sponsors
Instituto do Coracao
Study design
Observational model
COHORT
Time perspective
RETROSPECTIVE
Eligibility
Sex/Gender
ALL
Age
18 Years to No maximum
Healthy volunteers
No
Inclusion criteria
* Patients with stable multivessel coronary artery disease, defined as ≥70% stenosis in at least two major epicardial coronary arteries, with documented myocardial ischemia and clinical indication for surgical, percutaneous, or medical treatment.
Exclusion criteria
* Patients with limited life expectancy, severe left ventricular dysfunction (ejection fraction \<35%), recent acute coronary syndrome, recent revascularization procedures, significant valvular disease, chronic kidney disease (creatinine ≥2.0 mg/dL), active malignancy, or inability to complete long-term follow-up.
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Non-fatal myocardial infarction related to the treated coronary artery | Up to 5 years of follow-up |
| Cardiac death attributable to the treated coronary artery | Up to 5 years of follow-up |
Outcome results
None listed