Prognostic impact of secondary prevention after coronary artery bypass grafting-insights from the TiCAB trial.
Обработка статьи · этапы, ошибки и управление
Ошибки и ограничения
История · было → стало
Состояние обновляется каждые 5 секунд, пока блок открыт. Процент показывается только там, где известен объём работы. Пауза останавливает продолжение этапа; текущий запрос к источнику может завершиться.
Heer Tobias, von Scheidt Moritz, Boening Andreas, Heyken Clarissa, Gusmini Friederike, de Waha Antoinette, Kuna Constantin, Fach Andreas, Grothusen Christina, Oberhoffer Martin, Knosalla Christoph, Walther Thomas, Danner Bernhard C, Misfeld Martin, Wimmer-Greinecker Gerhard, Siepe Matthias, Grubitzsch Herko, Joost Alexander, Schaefer Andreas, Conradi Lenard, Cremer Jochen, Hamm Christian, Lange Rüdiger, Radke Peter W, Schulz Rainer, Laufer Günther, Grieshaber Philippe, Attmann Tim, Schmoeckel Michael, Meyer Alexander, Ziegelhöffer Tibor, Hambrecht Rainer, Sandner Sigrid E, Kastrati Adnan, Schunkert Heribert, Zeymer Uwe
Аннотация
METHODS: Data were taken from the randomized 'Ticagrelor in CABG' trial. From April 2013 until April 2017, patients who underwent CABG were included. For the present analysis, we compared patients who were treated with optimal medical secondary prevention with those where 1 or more of the recommended medications were missing.
RESULTS: Follow-up data at 12 months were available in 1807 patients. About half (54%) of them were treated with optimal secondary prevention. All-cause mortality [0.5% vs 3.5%, hazard ratio (HR) 0.14 (0.05-0.37), P < 0.01], cardiovascular mortality [0.1% vs 1.7%, HR 0.06 (0.01-0.46), P = 0.007] and major adverse events [6.5% vs 11.5%, HR 0.54 (0.39-0.74), P < 0.01] were significantly lower in the group with optimal secondary prevention. The multivariable model for the primary end point based on binary concordance to guideline recommended therapy identified 3 independent factors: adherence to guideline recommended therapy [HR 0.55 (0.39-0.78), P < 0.001]; normal renal function [HR 0.99 (0.98-0.99), P = 0.040]; and off-pump surgery [HR 2.06 (1.02-4.18), P = 0.045].
CONCLUSIONS: Only every second patient receives optimal secondary prevention after CABG. Guideline adherent secondary prevention therapy is associated with lower mid-term mortality and less adverse cardiovascular events after 12 months.