Impact of number of vessels disease on outcome of patients with stable coronary artery disease: 5-year follow-up of the Medical, Angioplasty, and bypass Surgery Study (MASS)
Objective: To evaluate whether the number of vessels disease has an impact on clinical outcomes as well as on therapeutic results accordingly to medical, percutaneous, or surgery treatment in chronic coronary artery disease. Methods: We evaluated 825 individuals enrolled in MASS study, a randomized...
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| Veröffentlicht in: | European journal of cardio-thoracic surgery 2008-03, Vol.33 (3), p.349-354 |
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| creator | Lopes, Neuza Helena Paulitsch, Felipe da Silva Gois, Aécio F. Pereira, Alexandre C. Stolf, Noedir A. Dallan, Luis Oliveira Ramires, José A.F. Hueb, Whady A. |
| description | Objective: To evaluate whether the number of vessels disease has an impact on clinical outcomes as well as on therapeutic results accordingly to medical, percutaneous, or surgery treatment in chronic coronary artery disease. Methods: We evaluated 825 individuals enrolled in MASS study, a randomized study to compare treatment options for single or multivessel coronary artery disease with preserved left ventricular function, prospectively followed during 5 years. The incidence of overall mortality and the composite end-point of death, myocardial infarction, and refractory angina were compared in three groups: single vessel disease (SVD n = 214), two-vessel disease (2VD n = 253) and three-vessel disease (3VD n = 358). The relationship between baseline variables and the composite end-point was assessed using a Cox proportional hazards survival model. Results: Most baseline characteristics were similar among groups, except age (younger in SVD and older in 3VD, p |
| doi_str_mv | 10.1016/j.ejcts.2007.11.025 |
| format | Article |
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Methods: We evaluated 825 individuals enrolled in MASS study, a randomized study to compare treatment options for single or multivessel coronary artery disease with preserved left ventricular function, prospectively followed during 5 years. The incidence of overall mortality and the composite end-point of death, myocardial infarction, and refractory angina were compared in three groups: single vessel disease (SVD n = 214), two-vessel disease (2VD n = 253) and three-vessel disease (3VD n = 358). The relationship between baseline variables and the composite end-point was assessed using a Cox proportional hazards survival model. Results: Most baseline characteristics were similar among groups, except age (younger in SVD and older in 3VD, p < 0.001), lower incidence of hypertension in SVD (p < 0.0001), and lower levels of total and LDL-cholesterol in 3VD (p = 0.004 and p = 0.005, respectively). There were no statistical differences in composite end-point in 5 years among groups independent of the kind of treatment; however, there was a higher mortality rate in 3VD (p < 0.001). When we stratified our analysis for each treatment option, bypass surgery was associated with a lower number of composite end-point in all groups (SVD p < 0.001, 2VD p = 0.002, 3VD p < 0.001). In multivariate analysis, we found higher mortality risk in 3VD comparing to SVD (p = 0.005, HR 3.14, 95%CI 1.4–7.0). Conclusion: Three-vessel disease was associated with worse prognosis compared to single- or two-vessel disease in patients with stable coronary disease and preserved ventricular function at 5-year follow-up. In addition, event-free survival rates were higher after bypass surgery, independent of the number of vessels diseased in these subsets of patients.</description><identifier>ISSN: 1010-7940</identifier><identifier>EISSN: 1873-734X</identifier><identifier>DOI: 10.1016/j.ejcts.2007.11.025</identifier><identifier>PMID: 18249128</identifier><identifier>CODEN: EJCSE7</identifier><language>eng</language><publisher>Amsterdam: Elsevier Science B.V</publisher><subject>Aged ; Angina Pectoris - epidemiology ; Angioplasty ; Angioplasty - mortality ; Biological and medical sciences ; Cardiology. Vascular system ; Coronary Artery Bypass - mortality ; Coronary disease ; Coronary Disease - mortality ; Coronary Disease - pathology ; Coronary Disease - surgery ; Coronary heart disease ; Diseases of the cardiovascular system ; Female ; Follow-Up Studies ; Heart ; Hospital Mortality ; Humans ; Male ; Medical sciences ; Middle Aged ; Myocardial Infarction - epidemiology ; Number of vessels disease ; Pneumology ; Postoperative Complications ; Prognosis ; Proportional Hazards Models ; Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) ; Surgery ; Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases ; Surgery of the heart</subject><ispartof>European journal of cardio-thoracic surgery, 2008-03, Vol.33 (3), p.349-354</ispartof><rights>European Association for Cardio-Thoracic Surgery © 2007 European Association for Cardio-Thoracic Surgery 2007</rights><rights>2008 INIST-CNRS</rights><lds50>peer_reviewed</lds50><oa>free_for_read</oa><woscitedreferencessubscribed>false</woscitedreferencessubscribed><citedby>FETCH-LOGICAL-c490t-1e40152f7932f4759cf0280d9bea11231728974ce1039c27be54c644b35008b23</citedby></display><links><openurl>$$Topenurl_article</openurl><openurlfulltext>$$Topenurlfull_article</openurlfulltext><thumbnail>$$Tsyndetics_thumb_exl</thumbnail><link.rule.ids>314,776,780,27901,27902</link.rule.ids><backlink>$$Uhttp://pascal-francis.inist.fr/vibad/index.php?action=getRecordDetail&idt=20145071$$DView record in Pascal Francis$$Hfree_for_read</backlink><backlink>$$Uhttps://www.ncbi.nlm.nih.gov/pubmed/18249128$$D View this record in MEDLINE/PubMed$$Hfree_for_read</backlink></links><search><creatorcontrib>Lopes, Neuza Helena</creatorcontrib><creatorcontrib>Paulitsch, Felipe da Silva</creatorcontrib><creatorcontrib>Gois, Aécio F.</creatorcontrib><creatorcontrib>Pereira, Alexandre C.</creatorcontrib><creatorcontrib>Stolf, Noedir A.</creatorcontrib><creatorcontrib>Dallan, Luis Oliveira</creatorcontrib><creatorcontrib>Ramires, José A.F.</creatorcontrib><creatorcontrib>Hueb, Whady A.</creatorcontrib><title>Impact of number of vessels disease on outcome of patients with stable coronary artery disease: 5-year follow-up of the Medical, Angioplasty, and bypass Surgery Study (MASS)</title><title>European journal of cardio-thoracic surgery</title><addtitle>Eur J Cardiothorac Surg</addtitle><addtitle>Eur J Cardiothorac Surg</addtitle><description>Objective: To evaluate whether the number of vessels disease has an impact on clinical outcomes as well as on therapeutic results accordingly to medical, percutaneous, or surgery treatment in chronic coronary artery disease. Methods: We evaluated 825 individuals enrolled in MASS study, a randomized study to compare treatment options for single or multivessel coronary artery disease with preserved left ventricular function, prospectively followed during 5 years. The incidence of overall mortality and the composite end-point of death, myocardial infarction, and refractory angina were compared in three groups: single vessel disease (SVD n = 214), two-vessel disease (2VD n = 253) and three-vessel disease (3VD n = 358). The relationship between baseline variables and the composite end-point was assessed using a Cox proportional hazards survival model. Results: Most baseline characteristics were similar among groups, except age (younger in SVD and older in 3VD, p < 0.001), lower incidence of hypertension in SVD (p < 0.0001), and lower levels of total and LDL-cholesterol in 3VD (p = 0.004 and p = 0.005, respectively). There were no statistical differences in composite end-point in 5 years among groups independent of the kind of treatment; however, there was a higher mortality rate in 3VD (p < 0.001). When we stratified our analysis for each treatment option, bypass surgery was associated with a lower number of composite end-point in all groups (SVD p < 0.001, 2VD p = 0.002, 3VD p < 0.001). In multivariate analysis, we found higher mortality risk in 3VD comparing to SVD (p = 0.005, HR 3.14, 95%CI 1.4–7.0). Conclusion: Three-vessel disease was associated with worse prognosis compared to single- or two-vessel disease in patients with stable coronary disease and preserved ventricular function at 5-year follow-up. In addition, event-free survival rates were higher after bypass surgery, independent of the number of vessels diseased in these subsets of patients.</description><subject>Aged</subject><subject>Angina Pectoris - epidemiology</subject><subject>Angioplasty</subject><subject>Angioplasty - mortality</subject><subject>Biological and medical sciences</subject><subject>Cardiology. Vascular system</subject><subject>Coronary Artery Bypass - mortality</subject><subject>Coronary disease</subject><subject>Coronary Disease - mortality</subject><subject>Coronary Disease - pathology</subject><subject>Coronary Disease - surgery</subject><subject>Coronary heart disease</subject><subject>Diseases of the cardiovascular system</subject><subject>Female</subject><subject>Follow-Up Studies</subject><subject>Heart</subject><subject>Hospital Mortality</subject><subject>Humans</subject><subject>Male</subject><subject>Medical sciences</subject><subject>Middle Aged</subject><subject>Myocardial Infarction - epidemiology</subject><subject>Number of vessels disease</subject><subject>Pneumology</subject><subject>Postoperative Complications</subject><subject>Prognosis</subject><subject>Proportional Hazards Models</subject><subject>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</subject><subject>Surgery</subject><subject>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</subject><subject>Surgery of the heart</subject><issn>1010-7940</issn><issn>1873-734X</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNqNkdtu1DAQhiMEoqXwBEjINyCQmjA-ZL3hrqoordSKwwKtuLEcZ9JmSeLgcSj7ULwjCbsqt1zNSP7-39J8SfKUQ8aBL16vM1y7SJkA0BnnGYj8XrLPl1qmWqqr-9MOHFJdKNhLHhGtAWAhhX6Y7PGlUAUXy_3k91k3WBeZr1k_diWGefuJRNgSqxpCS8h8z_wYne9wfh1sbLCPxG6beMMo2rJF5nzwvQ0bZkPEaeyib1iebtAGVvu29bfpOMwN8QbZBVaNs-0hO-qvGz-0luLmkNm-YuVmsERsNYbruWkVx2rDXl4crVavHicPatsSPtnNg-TLydvPx6fp-ft3Z8dH56lTBcSUowKei1oXUtRK54WrQSyhKkq0nAvJtVgWWjnkIAsndIm5cgulSpkDLEshD5IX294h-B8jUjRdQw7b1vboRzIaJGjgegLlFnTBEwWszRCabrqD4WBmS2Zt_loysyXDuZksTalnu_qx7LD6l9lpmYDnO8DSdKQ62N41dMcJ4CoHzScu23J-HP7z53QbaCjir7uIDd_NQkudm9Orb-ZDfqkuP346MV_lH29Du1s</recordid><startdate>20080301</startdate><enddate>20080301</enddate><creator>Lopes, Neuza Helena</creator><creator>Paulitsch, Felipe da Silva</creator><creator>Gois, Aécio F.</creator><creator>Pereira, Alexandre C.</creator><creator>Stolf, Noedir A.</creator><creator>Dallan, Luis Oliveira</creator><creator>Ramires, José A.F.</creator><creator>Hueb, Whady A.</creator><general>Elsevier Science B.V</general><general>Elsevier Science</general><scope>BSCLL</scope><scope>IQODW</scope><scope>CGR</scope><scope>CUY</scope><scope>CVF</scope><scope>ECM</scope><scope>EIF</scope><scope>NPM</scope><scope>AAYXX</scope><scope>CITATION</scope><scope>7X8</scope></search><sort><creationdate>20080301</creationdate><title>Impact of number of vessels disease on outcome of patients with stable coronary artery disease: 5-year follow-up of the Medical, Angioplasty, and bypass Surgery Study (MASS)</title><author>Lopes, Neuza Helena ; Paulitsch, Felipe da Silva ; Gois, Aécio F. ; Pereira, Alexandre C. ; Stolf, Noedir A. ; Dallan, Luis Oliveira ; Ramires, José A.F. ; Hueb, Whady A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c490t-1e40152f7932f4759cf0280d9bea11231728974ce1039c27be54c644b35008b23</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Aged</topic><topic>Angina Pectoris - epidemiology</topic><topic>Angioplasty</topic><topic>Angioplasty - mortality</topic><topic>Biological and medical sciences</topic><topic>Cardiology. Vascular system</topic><topic>Coronary Artery Bypass - mortality</topic><topic>Coronary disease</topic><topic>Coronary Disease - mortality</topic><topic>Coronary Disease - pathology</topic><topic>Coronary Disease - surgery</topic><topic>Coronary heart disease</topic><topic>Diseases of the cardiovascular system</topic><topic>Female</topic><topic>Follow-Up Studies</topic><topic>Heart</topic><topic>Hospital Mortality</topic><topic>Humans</topic><topic>Male</topic><topic>Medical sciences</topic><topic>Middle Aged</topic><topic>Myocardial Infarction - epidemiology</topic><topic>Number of vessels disease</topic><topic>Pneumology</topic><topic>Postoperative Complications</topic><topic>Prognosis</topic><topic>Proportional Hazards Models</topic><topic>Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects)</topic><topic>Surgery</topic><topic>Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases</topic><topic>Surgery of the heart</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Lopes, Neuza Helena</creatorcontrib><creatorcontrib>Paulitsch, Felipe da Silva</creatorcontrib><creatorcontrib>Gois, Aécio F.</creatorcontrib><creatorcontrib>Pereira, Alexandre C.</creatorcontrib><creatorcontrib>Stolf, Noedir A.</creatorcontrib><creatorcontrib>Dallan, Luis Oliveira</creatorcontrib><creatorcontrib>Ramires, José A.F.</creatorcontrib><creatorcontrib>Hueb, Whady A.</creatorcontrib><collection>Istex</collection><collection>Pascal-Francis</collection><collection>Medline</collection><collection>MEDLINE</collection><collection>MEDLINE (Ovid)</collection><collection>MEDLINE</collection><collection>MEDLINE</collection><collection>PubMed</collection><collection>CrossRef</collection><collection>MEDLINE - Academic</collection><jtitle>European journal of cardio-thoracic surgery</jtitle></facets><delivery><delcategory>Remote Search Resource</delcategory><fulltext>fulltext</fulltext></delivery><addata><au>Lopes, Neuza Helena</au><au>Paulitsch, Felipe da Silva</au><au>Gois, Aécio F.</au><au>Pereira, Alexandre C.</au><au>Stolf, Noedir A.</au><au>Dallan, Luis Oliveira</au><au>Ramires, José A.F.</au><au>Hueb, Whady A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Impact of number of vessels disease on outcome of patients with stable coronary artery disease: 5-year follow-up of the Medical, Angioplasty, and bypass Surgery Study (MASS)</atitle><jtitle>European journal of cardio-thoracic surgery</jtitle><stitle>Eur J Cardiothorac Surg</stitle><addtitle>Eur J Cardiothorac Surg</addtitle><date>2008-03-01</date><risdate>2008</risdate><volume>33</volume><issue>3</issue><spage>349</spage><epage>354</epage><pages>349-354</pages><issn>1010-7940</issn><eissn>1873-734X</eissn><coden>EJCSE7</coden><abstract>Objective: To evaluate whether the number of vessels disease has an impact on clinical outcomes as well as on therapeutic results accordingly to medical, percutaneous, or surgery treatment in chronic coronary artery disease. Methods: We evaluated 825 individuals enrolled in MASS study, a randomized study to compare treatment options for single or multivessel coronary artery disease with preserved left ventricular function, prospectively followed during 5 years. The incidence of overall mortality and the composite end-point of death, myocardial infarction, and refractory angina were compared in three groups: single vessel disease (SVD n = 214), two-vessel disease (2VD n = 253) and three-vessel disease (3VD n = 358). The relationship between baseline variables and the composite end-point was assessed using a Cox proportional hazards survival model. Results: Most baseline characteristics were similar among groups, except age (younger in SVD and older in 3VD, p < 0.001), lower incidence of hypertension in SVD (p < 0.0001), and lower levels of total and LDL-cholesterol in 3VD (p = 0.004 and p = 0.005, respectively). There were no statistical differences in composite end-point in 5 years among groups independent of the kind of treatment; however, there was a higher mortality rate in 3VD (p < 0.001). When we stratified our analysis for each treatment option, bypass surgery was associated with a lower number of composite end-point in all groups (SVD p < 0.001, 2VD p = 0.002, 3VD p < 0.001). In multivariate analysis, we found higher mortality risk in 3VD comparing to SVD (p = 0.005, HR 3.14, 95%CI 1.4–7.0). Conclusion: Three-vessel disease was associated with worse prognosis compared to single- or two-vessel disease in patients with stable coronary disease and preserved ventricular function at 5-year follow-up. In addition, event-free survival rates were higher after bypass surgery, independent of the number of vessels diseased in these subsets of patients.</abstract><cop>Amsterdam</cop><pub>Elsevier Science B.V</pub><pmid>18249128</pmid><doi>10.1016/j.ejcts.2007.11.025</doi><tpages>6</tpages><oa>free_for_read</oa></addata></record> |
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| subjects | Aged Angina Pectoris - epidemiology Angioplasty Angioplasty - mortality Biological and medical sciences Cardiology. Vascular system Coronary Artery Bypass - mortality Coronary disease Coronary Disease - mortality Coronary Disease - pathology Coronary Disease - surgery Coronary heart disease Diseases of the cardiovascular system Female Follow-Up Studies Heart Hospital Mortality Humans Male Medical sciences Middle Aged Myocardial Infarction - epidemiology Number of vessels disease Pneumology Postoperative Complications Prognosis Proportional Hazards Models Radiotherapy. Instrumental treatment. Physiotherapy. Reeducation. Rehabilitation, orthophony, crenotherapy. Diet therapy and various other treatments (general aspects) Surgery Surgery (general aspects). Transplantations, organ and tissue grafts. Graft diseases Surgery of the heart |
| title | Impact of number of vessels disease on outcome of patients with stable coronary artery disease: 5-year follow-up of the Medical, Angioplasty, and bypass Surgery Study (MASS) |
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