Validation of the Appropriate Use Criteria for Percutaneous Coronary Intervention in Patients With Stable Coronary Artery Disease (from the COURAGE Trial)
| Autor: | Marcin Dada, Paul Chan, Koon K. Teo, Brahmajee K. Nallamothu, William J. Kostuk, Steven P. Sedlis, Pamela M. Hartigan, G.B. John Mancini, William S. Weintraub, Steven M. Bradley, Daniel S. Berman, David J. Maron, William E. Boden, John A. Spertus |
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| Rok vydání: | 2015 |
| Předmět: |
Male
medicine.medical_specialty medicine.medical_treatment Coronary Artery Disease Coronary Angiography Article Appropriate Use Criteria law.invention Angina Coronary artery disease Electrocardiography Percutaneous Coronary Intervention Randomized controlled trial law Surveys and Questionnaires Internal medicine medicine Humans cardiovascular diseases Myocardial infarction Retrospective Studies business.industry Hazard ratio Reproducibility of Results Percutaneous coronary intervention Middle Aged medicine.disease Treatment Outcome Conventional PCI Quality of Life Cardiology Female Cardiology and Cardiovascular Medicine business |
| Zdroj: | The American Journal of Cardiology. 116:167-173 |
| ISSN: | 0002-9149 |
| DOI: | 10.1016/j.amjcard.2015.03.057 |
| Popis: | Establishing the validity of appropriate use criteria (AUC) for percutaneous coronary intervention (PCI) in the setting of stable ischemic heart disease can support their adoption for quality improvement. We conducted a post hoc analysis of 2,287 Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation trial patients with stable ischemic heart disease randomized to PCI with optimal medical therapy (OMT) or OMT alone. Within appropriateness categories, we compared rates of death, myocardial infarction, revascularization subsequent to initial therapy, and angina-specific health status as determined by the Seattle Angina Questionnaire in patients randomized to PCI D OMT to those randomized to OMT alone. A total of 1,987 patients (87.9%) were mapped to the 2012 publication of the AUC, with 1,334 (67.1%) classified as appropriate, 551 (27.7%) uncertain, and 102 (5.1%) as inappropriate. There were no significant differences between PCI and OMT alone in the rate of mortality and myocardial infarction by appropriateness classification. Rates of revascularization were significantly lower in patients initially receiving PCI D OMT who were classified as appropriate (hazard ratio 0.65; 95% confidence interval 0.53 to 0.80; p |
| Databáze: | OpenAIRE |
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