Long-Term Follow-Up of Complete Versus Lesion-Only Revascularization in STEMI and Multivessel Disease: The CvLPRIT Trial
Randomized trials have shown that complete revascularization in patients with ST-segment elevation myocardial infarction (MI) with multivessel disease results in lower major adverse cardiovascular events (MACE) (all-cause death, MI, ischemia-driven revascularization, heart failure). The goal of this...
Gespeichert in:
| Veröffentlicht in: | Journal of the American College of Cardiology 2019-12, Vol.74 (25), p.3083-3094 |
|---|---|
| Hauptverfasser: | , , , , , , , , , , , |
| Format: | Artikel |
| Sprache: | eng |
| Schlagworte: | |
| Online-Zugang: | Volltext |
| Tags: |
Tag hinzufügen
Keine Tags, Fügen Sie den ersten Tag hinzu!
|
| container_end_page | 3094 |
|---|---|
| container_issue | 25 |
| container_start_page | 3083 |
| container_title | Journal of the American College of Cardiology |
| container_volume | 74 |
| creator | Gershlick, Anthony H Banning, Amerjeet S Parker, Emma Wang, Duolao Budgeon, Charley A Kelly, Damian J Kane, Peter O Dalby, Miles Hetherington, Simon L McCann, Gerry P Greenwood, John P Curzen, Nick |
| description | Randomized trials have shown that complete revascularization in patients with ST-segment elevation myocardial infarction (MI) with multivessel disease results in lower major adverse cardiovascular events (MACE) (all-cause death, MI, ischemia-driven revascularization, heart failure).
The goal of this study was to determine whether the benefits of complete revascularization are sustained long-term and their impact on hard endpoints.
CvLPRIT (Complete versus Lesion-only Primary PCI Trial) was a randomized trial of complete inpatient revascularization versus infarct-related artery revascularization only at the index admission. Randomized patients have been followed longer-term. The components of the original primary endpoint were collected from physical and electronic patient records, and from local databases for all readmissions.
The median follow-up (achieved in >90% patients) from randomization to first event or last follow-up was 5.6 years (0.0 to 7.3 years). The primary MACE endpoint rate at this time point was 24.0% in the complete revascularization group but 37.7% of the infarct-related artery-only group (hazard ratio: 0.57; 95% confidence interval: 0.37 to 0.87; p = 0.0079). The composite endpoint of all-cause death/MI was 10.0% in the complete revascularization group versus 18.5% in the infarct-related artery-only group (hazard ratio: 0.47; 95% confidence interval: 0.25 to 0.89; p = 0.0175). In a landmark analysis (from 12 months to final follow-up), there was no significant difference between MACE, death/MI, and individual components of the primary endpoint.
Long-term follow-up of the CvLPRIT trial shows that the significantly lower rate of MACE in the complete revascularization group, previously seen at 12 months, is sustained to a median of 5.6 years. A significant difference in composite all-cause death/MI favoring the complete revascularization was also observed. (Complete versus Lesion-only Primary PCI Trial; ISRCTN70913605). |
| doi_str_mv | 10.1016/j.jacc.2019.10.033 |
| format | Article |
| fullrecord | <record><control><sourceid>proquest_pubme</sourceid><recordid>TN_cdi_proquest_miscellaneous_2329730185</recordid><sourceformat>XML</sourceformat><sourcesystem>PC</sourcesystem><sourcerecordid>2329730185</sourcerecordid><originalsourceid>FETCH-LOGICAL-p169t-e2ad170523be53ee6d6a9cc87be13545acfe2d0a65e5454307479ee4bec7cf153</originalsourceid><addsrcrecordid>eNpd0EtOwzAQBmALgWgpXIAFssSGTYofsV2zQ-VVKQgEKdvKdaaQyolDnBTBaXqWnowgyobVaH59Go1-hI4pGVJC5flyuDTWDhmhuguGhPMd1KdCjCIutNpFfaK4iCjRqocOQlgSQuSI6n3U43QkpJZxH30lvnyNUqgLfOOd8x_RtMJ-gce-qBw0gF-gDm3ACYTcl9FD6T7xE6xMsK0zdf5lmi7GeYmf0-v7yWZtymyzvm9dk68gBHD4Kg9gAlzg9A3weJU8Pk1SnNa5cYdob2FcgKPtHKDpzXU6vouSh9vJ-DKJKip1EwEzGVVEMD4HwQFkJo22dqTmQLmIhbELYBkxUkC3xZyoWGmAeA5W2QUVfIDOfu9WtX9vITSzIg8WnDMl-DbMGGdacdJV0tHTf3Tp27rsvvtRilPGmOzUyVa18wKyWVXnhak_Z3-t8m_9s3vJ</addsrcrecordid><sourcetype>Aggregation Database</sourcetype><iscdi>true</iscdi><recordtype>article</recordtype><pqid>2327312226</pqid></control><display><type>article</type><title>Long-Term Follow-Up of Complete Versus Lesion-Only Revascularization in STEMI and Multivessel Disease: The CvLPRIT Trial</title><source>MEDLINE</source><source>Elsevier ScienceDirect Journals Complete</source><source>Alma/SFX Local Collection</source><source>EZB Electronic Journals Library</source><creator>Gershlick, Anthony H ; Banning, Amerjeet S ; Parker, Emma ; Wang, Duolao ; Budgeon, Charley A ; Kelly, Damian J ; Kane, Peter O ; Dalby, Miles ; Hetherington, Simon L ; McCann, Gerry P ; Greenwood, John P ; Curzen, Nick</creator><creatorcontrib>Gershlick, Anthony H ; Banning, Amerjeet S ; Parker, Emma ; Wang, Duolao ; Budgeon, Charley A ; Kelly, Damian J ; Kane, Peter O ; Dalby, Miles ; Hetherington, Simon L ; McCann, Gerry P ; Greenwood, John P ; Curzen, Nick</creatorcontrib><description>Randomized trials have shown that complete revascularization in patients with ST-segment elevation myocardial infarction (MI) with multivessel disease results in lower major adverse cardiovascular events (MACE) (all-cause death, MI, ischemia-driven revascularization, heart failure).
The goal of this study was to determine whether the benefits of complete revascularization are sustained long-term and their impact on hard endpoints.
CvLPRIT (Complete versus Lesion-only Primary PCI Trial) was a randomized trial of complete inpatient revascularization versus infarct-related artery revascularization only at the index admission. Randomized patients have been followed longer-term. The components of the original primary endpoint were collected from physical and electronic patient records, and from local databases for all readmissions.
The median follow-up (achieved in >90% patients) from randomization to first event or last follow-up was 5.6 years (0.0 to 7.3 years). The primary MACE endpoint rate at this time point was 24.0% in the complete revascularization group but 37.7% of the infarct-related artery-only group (hazard ratio: 0.57; 95% confidence interval: 0.37 to 0.87; p = 0.0079). The composite endpoint of all-cause death/MI was 10.0% in the complete revascularization group versus 18.5% in the infarct-related artery-only group (hazard ratio: 0.47; 95% confidence interval: 0.25 to 0.89; p = 0.0175). In a landmark analysis (from 12 months to final follow-up), there was no significant difference between MACE, death/MI, and individual components of the primary endpoint.
Long-term follow-up of the CvLPRIT trial shows that the significantly lower rate of MACE in the complete revascularization group, previously seen at 12 months, is sustained to a median of 5.6 years. A significant difference in composite all-cause death/MI favoring the complete revascularization was also observed. (Complete versus Lesion-only Primary PCI Trial; ISRCTN70913605).</description><identifier>ISSN: 0735-1097</identifier><identifier>EISSN: 1558-3597</identifier><identifier>DOI: 10.1016/j.jacc.2019.10.033</identifier><identifier>PMID: 31856964</identifier><language>eng</language><publisher>United States: Elsevier Limited</publisher><subject>Aged ; Angioplasty ; Cardiology ; Clinical trials ; Confidence intervals ; Congestive heart failure ; Data collection ; Death ; Female ; Follow-Up Studies ; Health hazards ; Heart attacks ; Heart failure ; Humans ; Intention to Treat Analysis ; Ischemia ; Lesions ; Male ; Middle Aged ; Mortality ; Myocardial infarction ; Patients ; Percutaneous Coronary Intervention - mortality ; Percutaneous Coronary Intervention - standards ; ST Elevation Myocardial Infarction - therapy ; United Kingdom - epidemiology</subject><ispartof>Journal of the American College of Cardiology, 2019-12, Vol.74 (25), p.3083-3094</ispartof><rights>Copyright © 2019 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.</rights><rights>2019. American College of Cardiology Foundation</rights><lds50>peer_reviewed</lds50><woscitedreferencessubscribed>false</woscitedreferencessubscribed></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/31856964$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Gershlick, Anthony H</creatorcontrib><creatorcontrib>Banning, Amerjeet S</creatorcontrib><creatorcontrib>Parker, Emma</creatorcontrib><creatorcontrib>Wang, Duolao</creatorcontrib><creatorcontrib>Budgeon, Charley A</creatorcontrib><creatorcontrib>Kelly, Damian J</creatorcontrib><creatorcontrib>Kane, Peter O</creatorcontrib><creatorcontrib>Dalby, Miles</creatorcontrib><creatorcontrib>Hetherington, Simon L</creatorcontrib><creatorcontrib>McCann, Gerry P</creatorcontrib><creatorcontrib>Greenwood, John P</creatorcontrib><creatorcontrib>Curzen, Nick</creatorcontrib><title>Long-Term Follow-Up of Complete Versus Lesion-Only Revascularization in STEMI and Multivessel Disease: The CvLPRIT Trial</title><title>Journal of the American College of Cardiology</title><addtitle>J Am Coll Cardiol</addtitle><description>Randomized trials have shown that complete revascularization in patients with ST-segment elevation myocardial infarction (MI) with multivessel disease results in lower major adverse cardiovascular events (MACE) (all-cause death, MI, ischemia-driven revascularization, heart failure).
The goal of this study was to determine whether the benefits of complete revascularization are sustained long-term and their impact on hard endpoints.
CvLPRIT (Complete versus Lesion-only Primary PCI Trial) was a randomized trial of complete inpatient revascularization versus infarct-related artery revascularization only at the index admission. Randomized patients have been followed longer-term. The components of the original primary endpoint were collected from physical and electronic patient records, and from local databases for all readmissions.
The median follow-up (achieved in >90% patients) from randomization to first event or last follow-up was 5.6 years (0.0 to 7.3 years). The primary MACE endpoint rate at this time point was 24.0% in the complete revascularization group but 37.7% of the infarct-related artery-only group (hazard ratio: 0.57; 95% confidence interval: 0.37 to 0.87; p = 0.0079). The composite endpoint of all-cause death/MI was 10.0% in the complete revascularization group versus 18.5% in the infarct-related artery-only group (hazard ratio: 0.47; 95% confidence interval: 0.25 to 0.89; p = 0.0175). In a landmark analysis (from 12 months to final follow-up), there was no significant difference between MACE, death/MI, and individual components of the primary endpoint.
Long-term follow-up of the CvLPRIT trial shows that the significantly lower rate of MACE in the complete revascularization group, previously seen at 12 months, is sustained to a median of 5.6 years. A significant difference in composite all-cause death/MI favoring the complete revascularization was also observed. (Complete versus Lesion-only Primary PCI Trial; ISRCTN70913605).</description><subject>Aged</subject><subject>Angioplasty</subject><subject>Cardiology</subject><subject>Clinical trials</subject><subject>Confidence intervals</subject><subject>Congestive heart failure</subject><subject>Data collection</subject><subject>Death</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Health hazards</subject><subject>Heart attacks</subject><subject>Heart failure</subject><subject>Humans</subject><subject>Intention to Treat Analysis</subject><subject>Ischemia</subject><subject>Lesions</subject><subject>Male</subject><subject>Middle Aged</subject><subject>Mortality</subject><subject>Myocardial infarction</subject><subject>Patients</subject><subject>Percutaneous Coronary Intervention - mortality</subject><subject>Percutaneous Coronary Intervention - standards</subject><subject>ST Elevation Myocardial Infarction - therapy</subject><subject>United Kingdom - epidemiology</subject><issn>0735-1097</issn><issn>1558-3597</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2019</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNpd0EtOwzAQBmALgWgpXIAFssSGTYofsV2zQ-VVKQgEKdvKdaaQyolDnBTBaXqWnowgyobVaH59Go1-hI4pGVJC5flyuDTWDhmhuguGhPMd1KdCjCIutNpFfaK4iCjRqocOQlgSQuSI6n3U43QkpJZxH30lvnyNUqgLfOOd8x_RtMJ-gce-qBw0gF-gDm3ACYTcl9FD6T7xE6xMsK0zdf5lmi7GeYmf0-v7yWZtymyzvm9dk68gBHD4Kg9gAlzg9A3weJU8Pk1SnNa5cYdob2FcgKPtHKDpzXU6vouSh9vJ-DKJKip1EwEzGVVEMD4HwQFkJo22dqTmQLmIhbELYBkxUkC3xZyoWGmAeA5W2QUVfIDOfu9WtX9vITSzIg8WnDMl-DbMGGdacdJV0tHTf3Tp27rsvvtRilPGmOzUyVa18wKyWVXnhak_Z3-t8m_9s3vJ</recordid><startdate>20191224</startdate><enddate>20191224</enddate><creator>Gershlick, Anthony H</creator><creator>Banning, Amerjeet S</creator><creator>Parker, Emma</creator><creator>Wang, Duolao</creator><creator>Budgeon, Charley A</creator><creator>Kelly, Damian J</creator><creator>Kane, Peter O</creator><creator>Dalby, Miles</creator><creator>Hetherington, Simon L</creator><creator>McCann, Gerry P</creator><creator>Greenwood, John P</creator><creator>Curzen, Nick</creator><general>Elsevier Limited</general><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>7T5</scope><scope>7TK</scope><scope>H94</scope><scope>K9.</scope><scope>NAPCQ</scope><scope>7X8</scope></search><sort><creationdate>20191224</creationdate><title>Long-Term Follow-Up of Complete Versus Lesion-Only Revascularization in STEMI and Multivessel Disease: The CvLPRIT Trial</title><author>Gershlick, Anthony H ; Banning, Amerjeet S ; Parker, Emma ; Wang, Duolao ; Budgeon, Charley A ; Kelly, Damian J ; Kane, Peter O ; Dalby, Miles ; Hetherington, Simon L ; McCann, Gerry P ; Greenwood, John P ; Curzen, Nick</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-p169t-e2ad170523be53ee6d6a9cc87be13545acfe2d0a65e5454307479ee4bec7cf153</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2019</creationdate><topic>Aged</topic><topic>Angioplasty</topic><topic>Cardiology</topic><topic>Clinical trials</topic><topic>Confidence intervals</topic><topic>Congestive heart failure</topic><topic>Data collection</topic><topic>Death</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Health hazards</topic><topic>Heart attacks</topic><topic>Heart failure</topic><topic>Humans</topic><topic>Intention to Treat Analysis</topic><topic>Ischemia</topic><topic>Lesions</topic><topic>Male</topic><topic>Middle Aged</topic><topic>Mortality</topic><topic>Myocardial infarction</topic><topic>Patients</topic><topic>Percutaneous Coronary Intervention - mortality</topic><topic>Percutaneous Coronary Intervention - standards</topic><topic>ST Elevation Myocardial Infarction - therapy</topic><topic>United Kingdom - epidemiology</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Gershlick, Anthony H</creatorcontrib><creatorcontrib>Banning, Amerjeet S</creatorcontrib><creatorcontrib>Parker, Emma</creatorcontrib><creatorcontrib>Wang, Duolao</creatorcontrib><creatorcontrib>Budgeon, Charley A</creatorcontrib><creatorcontrib>Kelly, Damian J</creatorcontrib><creatorcontrib>Kane, Peter O</creatorcontrib><creatorcontrib>Dalby, Miles</creatorcontrib><creatorcontrib>Hetherington, Simon L</creatorcontrib><creatorcontrib>McCann, Gerry P</creatorcontrib><creatorcontrib>Greenwood, John P</creatorcontrib><creatorcontrib>Curzen, Nick</creatorcontrib><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>Immunology Abstracts</collection><collection>Neurosciences Abstracts</collection><collection>AIDS and Cancer Research Abstracts</collection><collection>ProQuest Health & Medical Complete (Alumni)</collection><collection>Nursing & Allied Health Premium</collection><collection>MEDLINE - Academic</collection><jtitle>Journal of the American College of Cardiology</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Gershlick, Anthony H</au><au>Banning, Amerjeet S</au><au>Parker, Emma</au><au>Wang, Duolao</au><au>Budgeon, Charley A</au><au>Kelly, Damian J</au><au>Kane, Peter O</au><au>Dalby, Miles</au><au>Hetherington, Simon L</au><au>McCann, Gerry P</au><au>Greenwood, John P</au><au>Curzen, Nick</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Long-Term Follow-Up of Complete Versus Lesion-Only Revascularization in STEMI and Multivessel Disease: The CvLPRIT Trial</atitle><jtitle>Journal of the American College of Cardiology</jtitle><addtitle>J Am Coll Cardiol</addtitle><date>2019-12-24</date><risdate>2019</risdate><volume>74</volume><issue>25</issue><spage>3083</spage><epage>3094</epage><pages>3083-3094</pages><issn>0735-1097</issn><eissn>1558-3597</eissn><abstract>Randomized trials have shown that complete revascularization in patients with ST-segment elevation myocardial infarction (MI) with multivessel disease results in lower major adverse cardiovascular events (MACE) (all-cause death, MI, ischemia-driven revascularization, heart failure).
The goal of this study was to determine whether the benefits of complete revascularization are sustained long-term and their impact on hard endpoints.
CvLPRIT (Complete versus Lesion-only Primary PCI Trial) was a randomized trial of complete inpatient revascularization versus infarct-related artery revascularization only at the index admission. Randomized patients have been followed longer-term. The components of the original primary endpoint were collected from physical and electronic patient records, and from local databases for all readmissions.
The median follow-up (achieved in >90% patients) from randomization to first event or last follow-up was 5.6 years (0.0 to 7.3 years). The primary MACE endpoint rate at this time point was 24.0% in the complete revascularization group but 37.7% of the infarct-related artery-only group (hazard ratio: 0.57; 95% confidence interval: 0.37 to 0.87; p = 0.0079). The composite endpoint of all-cause death/MI was 10.0% in the complete revascularization group versus 18.5% in the infarct-related artery-only group (hazard ratio: 0.47; 95% confidence interval: 0.25 to 0.89; p = 0.0175). In a landmark analysis (from 12 months to final follow-up), there was no significant difference between MACE, death/MI, and individual components of the primary endpoint.
Long-term follow-up of the CvLPRIT trial shows that the significantly lower rate of MACE in the complete revascularization group, previously seen at 12 months, is sustained to a median of 5.6 years. A significant difference in composite all-cause death/MI favoring the complete revascularization was also observed. (Complete versus Lesion-only Primary PCI Trial; ISRCTN70913605).</abstract><cop>United States</cop><pub>Elsevier Limited</pub><pmid>31856964</pmid><doi>10.1016/j.jacc.2019.10.033</doi><tpages>12</tpages></addata></record> |
| fulltext | fulltext |
| identifier | ISSN: 0735-1097 |
| ispartof | Journal of the American College of Cardiology, 2019-12, Vol.74 (25), p.3083-3094 |
| issn | 0735-1097 1558-3597 |
| language | eng |
| recordid | cdi_proquest_miscellaneous_2329730185 |
| source | MEDLINE; Elsevier ScienceDirect Journals Complete; Alma/SFX Local Collection; EZB Electronic Journals Library |
| subjects | Aged Angioplasty Cardiology Clinical trials Confidence intervals Congestive heart failure Data collection Death Female Follow-Up Studies Health hazards Heart attacks Heart failure Humans Intention to Treat Analysis Ischemia Lesions Male Middle Aged Mortality Myocardial infarction Patients Percutaneous Coronary Intervention - mortality Percutaneous Coronary Intervention - standards ST Elevation Myocardial Infarction - therapy United Kingdom - epidemiology |
| title | Long-Term Follow-Up of Complete Versus Lesion-Only Revascularization in STEMI and Multivessel Disease: The CvLPRIT Trial |
| url | https://sfx.bib-bvb.de/sfx_tum?ctx_ver=Z39.88-2004&ctx_enc=info:ofi/enc:UTF-8&ctx_tim=2025-02-07T19%3A16%3A31IST&url_ver=Z39.88-2004&url_ctx_fmt=infofi/fmt:kev:mtx:ctx&rfr_id=info:sid/primo.exlibrisgroup.com:primo3-Article-proquest_pubme&rft_val_fmt=info:ofi/fmt:kev:mtx:journal&rft.genre=article&rft.atitle=Long-Term%20Follow-Up%20of%20Complete%20Versus%20Lesion-Only%20Revascularization%20in%20STEMI%C2%A0and%C2%A0Multivessel%20Disease:%20The%20CvLPRIT%20Trial&rft.jtitle=Journal%20of%20the%20American%20College%20of%20Cardiology&rft.au=Gershlick,%20Anthony%20H&rft.date=2019-12-24&rft.volume=74&rft.issue=25&rft.spage=3083&rft.epage=3094&rft.pages=3083-3094&rft.issn=0735-1097&rft.eissn=1558-3597&rft_id=info:doi/10.1016/j.jacc.2019.10.033&rft_dat=%3Cproquest_pubme%3E2329730185%3C/proquest_pubme%3E%3Curl%3E%3C/url%3E&disable_directlink=true&sfx.directlink=off&sfx.report_link=0&rft_id=info:oai/&rft_pqid=2327312226&rft_id=info:pmid/31856964&rfr_iscdi=true |