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Coronary Artery Disease: HELP
Articles by Kristine Roy
Based on 1 article published since 2010
(Why 1 article?)
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Between 2010 and 2020, Kristine Roy wrote the following article about Coronary Artery Disease.
 
+ Citations + Abstracts
1 Article Five-year outcomes in patients with left main disease treated with either percutaneous coronary intervention or coronary artery bypass grafting in the synergy between percutaneous coronary intervention with taxus and cardiac surgery trial. 2014

Morice, Marie-Claude / Serruys, Patrick W / Kappetein, A Pieter / Feldman, Ted E / Ståhle, Elisabeth / Colombo, Antonio / Mack, Michael J / Holmes, David R / Choi, James W / Ruzyllo, Witold / Religa, Grzegorz / Huang, Jian / Roy, Kristine / Dawkins, Keith D / Mohr, Friedrich. ·From the Institut Cardiovasculaire Paris Sud, Hopital Privé Jacques Cartier, Générale de santé, Massy, France (M.-C.M.) · Erasmus University Medical Center Rotterdam, Rotterdam, The Netherlands (P.W.S., A.P.K.) · Evanston Hospital, Evanston, IL (T.E.F.) · University Hospital Uppsala, Uppsala, Sweden (E.S.) · San Raffaele Scientific Institute, Milan, Italy (A.C.) · Medical City Hospital, Dallas, TX (M.J.M.) · Mayo Clinic, Rochester, MN (D.R.H.) · Baylor Heart and Vascular Hospital, Dallas, TX (J.W.C.) · Institute of Cardiology, Warsaw, Poland (W.R., G.R.) · Boston Scientific Corporation, Natick, MA (J.H., K.R., K.D.D.) · University of Leipzig Heart Center, Leipzig, Germany (F.M.). ·Circulation · Pubmed #24700706.

ABSTRACT: BACKGROUND: Current guidelines recommend coronary artery bypass graft surgery (CABG) when treating significant de novo left main coronary artery (LM) stenosis; however, percutaneous coronary intervention (PCI) has a class IIa indication for unprotected LM disease in selected patients. This analysis compares 5-year clinical outcomes in PCI- and CABG-treated LM patients in the Synergy Between PCI With Taxus and Cardiac Surgery (SYNTAX) trial, the largest trial in this group to date. METHODS AND RESULTS: The SYNTAX trial randomly assigned 1800 patients with LM or 3-vessel disease to receive either PCI (with TAXUS Express paclitaxel-eluting stents) or CABG. The unprotected LM cohort (N=705) was predefined and powered. Major adverse cardiac and cerebrovascular event rates at 5 years was 36.9% in PCI patients and 31.0% in CABG patients (hazard ratio, 1.23 [95% confidence interval, 0.95-1.59]; P=0.12). Mortality rate was 12.8% and 14.6% in PCI and CABG patients, respectively (hazard ratio, 0.88 [95% confidence interval, 0.58-1.32]; P=0.53). Stroke was significantly increased in the CABG group (PCI 1.5% versus CABG 4.3%; hazard ratio, 0.33 [95% confidence interval, 0.12-0.92]; P=0.03) and repeat revascularization in the PCI arm (26.7% versus 15.5%; hazard ratio, 1.82 [95% confidence interval, 1.28-2.57]; P<0.01). Major adverse cardiac and cerebrovascular events were similar between arms in patients with low/intermediate SYNTAX scores but significantly increased in PCI patients with high scores (≥33). CONCLUSIONS: At 5 years, no difference in overall major adverse cardiac and cerebrovascular events was found between treatment groups. PCI-treated patients had a lower stroke but a higher revascularization rate versus CABG. These results suggest that both treatments are valid options for LM patients. The extent of disease should accounted for when choosing between surgery and PCI, because patients with high SYNTAX scores seem to benefit more from surgery compared with those in the lower tertiles. CLINICAL TRIAL REGISTRATION URL: http://www.clinicaltrials.gov. Unique identifier: NCT00114972.