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dc.contributor.authorAlmeida, Adriana Silveira dept_BR
dc.contributor.authorFuchs, Sandra Cristina Pereira Costapt_BR
dc.contributor.authorFuchs, Felipe Costapt_BR
dc.contributor.authorSilva, Aline Gonçalves dapt_BR
dc.contributor.authorLucca, Marcelo Balbinotpt_BR
dc.contributor.authorScopel, Samuelpt_BR
dc.contributor.authorFuchs, Flávio Dannipt_BR
dc.date.accessioned2021-08-31T04:20:59Zpt_BR
dc.date.issued2020pt_BR
dc.identifier.issn1176-6344pt_BR
dc.identifier.urihttp://hdl.handle.net/10183/226315pt_BR
dc.description.abstractPurpose: To ascertain the most appropriate treatment for chronic, stable, coronary artery disease (CAD) in patients submitted to elective coronary angiography. Patients and Methods: A total of 814 patients included in the prospective cohort study were referred for elective coronary angiography and were followed up on average for 6±1.9 years. Main outcomes were all-cause death, cardiovascular death, non-fatal myocardial infarction (MI) and stroke and late revascularization and their combinations as major adverse cardiac and cerebral events (MACCE): MACCE-1 included cardiovascular death, nonfatal MI, and stroke; MACCE-2 was MACCE-1 plus late revascularization. Survival curves and adjusted Cox proportional hazard models were used to explore the association between the type of treatment and outcomes. Results: All-cause death was lower in participants submitted to percutaneous coronary intervention (PCI) (0.41, 0.16–1.03, P=0.057) compared to medical treatment (MT). Coronary-artery bypass grafting (CABG) had an overall trend for poorer outcomes: cardiovascular death 2.53 (0.42–15.10), combined cardiovascular death, nonfatal MI, and stroke 2.15 (0.73–6.31) and these events plus late revascularization (2.17, 0.86–5.49). The corresponding numbers for PCI were 0.27 (0.05–1.43) for cardiovascular death, 0.77 (0.32–1.84) for combined cardiovascular death, nonfatal MI, and stroke and 2.35 (1.16–4.77) with the addition of late revascularization. These trends were not influenced by baseline blood pressure, left ventricular ejection fraction and previous MI. Patients with diabetes mellitus had a significantly higher risk of recurrent revascularization when submitted to PCI than CABG. Conclusion: Patients with confirmed CAD in elective coronary angiography do not have a better prognosis when submitted to CABG comparatively to medical treatment. Patients treated with PCI had a trend for the lower incidence of combined cardiovascular events, at the expense of additional revascularization procedures. Patients without significant CAD had a similar prognosis than CAD patients treated with medical therapy.en
dc.format.mimetypeapplication/pdfpt_BR
dc.language.isoengpt_BR
dc.relation.ispartofVascular health and risk management. Auckland. Vol. 16, (2020), p. 285–297.pt_BR
dc.rightsOpen Accessen
dc.subjectDoenças cardiovascularespt_BR
dc.subjectStable coronary artery diseaseen
dc.subjectAngiografia coronáriapt_BR
dc.subjectSYNTAX scoreen
dc.subjectCoronary artery bypass graftingen
dc.subjectPercutaneous coronary interventionen
dc.subjectMyocardial revascularizationen
dc.titleEffectiveness of clinical, surgical and percutaneous treatment to prevent cardiovascular events in patients referred for elective coronary angiography: an observational studypt_BR
dc.typeArtigo de periódicopt_BR
dc.identifier.nrb001130062pt_BR
dc.type.originEstrangeiropt_BR


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