Long-Term Outcomes of Coronary-Artery Bypass Grafting versus Stent Implantation
Edward L. Hannan, Ph.D., Michael J. Racz, Ph.D., Gary Walford, M.D., Robert H. Jones, M.D., Thomas J. Ryan, M.D., Edward Bennett, M.D., Alfred T. Culliford, M.D., O. Wayne Isom, M.D., Jeffrey P. Gold, M.D., and Eric A. Rose, M.D.
Background Several studies have compared outcomes for coronary-arterybypass grafting (CABG) and percutaneous coronary intervention(PCI), but most were done before the availability of stenting,which has revolutionized the latter approach.
Methods We used New York's cardiac registries to identify 37,212patients with multivessel disease who underwent CABG and 22,102patients with multivessel disease who underwent PCI from January1, 1997, to December 31, 2000. We determined the rates of deathand subsequent revascularization within three years after theprocedure in various groups of patients according to the numberof diseased vessels and the presence or absence of involvementof the left anterior descending coronary artery. The rates ofadverse outcomes were adjusted by means of proportional-hazardsmethods to account for differences in patients' severity ofillness before revascularization.
Results Risk-adjusted survival rates were significantly higheramong patients who underwent CABG than among those who receiveda stent in all of the anatomical subgroups studied. For example,the adjusted hazard ratio for the long-term risk of death afterCABG relative to stent implantation was 0.64 (95 percent confidenceinterval, 0.56 to 0.74) for patients with three-vessel diseasewith involvement of the proximal left anterior descending coronaryartery and 0.76 (95 percent confidence interval, 0.60 to 0.96)for patients with two-vessel disease with involvement of thenonproximal left anterior descending coronary artery. Also,the three-year rates of revascularization were considerablyhigher in the stenting group than in the CABG group (7.8 percentvs. 0.3 percent for subsequent CABG and 27.3 percent vs. 4.6percent for subsequent PCI).
Conclusions For patients with two or more diseased coronaryarteries, CABG is associated with higher adjusted rates of long-termsurvival than stenting.
Coronary-artery bypass grafting (CABG) and percutaneous coronaryintervention (PCI) have long been the definitive aggressiveoptions for treating patients with coronary artery disease.In the past few years, several randomized clinical trials1,2,3,4,5,6,7,8,9,10,11,12,13,14,15and observational studies16,17,18,19,20 have examined the relativelong-term benefits of these interventions. However, with fewexceptions, these studies were conducted before the availabilityof stenting.8,11,13,15 We used observational data from a verylarge registry to compare short-term and long-term outcomesamong patients with multivessel disease who underwent CABG orstenting in New York State hospitals.
Methods
Databases
The two main databases used in the study were New York's twocardiac registries, the Cardiac Surgery Reporting System (CSRS)and the Percutaneous Coronary Intervention Reporting System(PCIRS). These databases include information about numerousrisk factors; admission, surgery, and discharge dates; and dischargestatus for all patients undergoing CABG and PCI in nonfederalhospitals in New York State.
To ensure that these registries are complete, data are matchedto New York State's acute care hospital-discharge data set,the Statewide Planning and Research Cooperative System (SPARCS),which is used for reimbursement. Also, reporting of in-hospitaldeaths is matched against SPARCS data, and hospitals are askedto resolve discrepancies. Accuracy of risk-factor reportingis ascertained by having the Department of Health's utilization-reviewagent audit hospitals' medical records. To identify deaths thatdid not occur in hospitals, we used patients' Social Securitynumbers to link New York's Vital Statistics Death File to thetwo registries. The institutional review board of the Universityof Albany approved the use of these data for this study.
Study Group and End Points
The study included New York residents with multivessel coronaryartery disease (defined as stenosis of at least 70 percent inat least two of the three main coronary arteries) who underwentisolated CABG or stent implantation for at least one lesionbetween January 1, 1997, and December 31, 2000, in New York.Patients who had previously undergone revascularization, thosewith disease of the left main coronary artery (defined as stenosisof more than 50 percent), and those who had an acute myocardialinfarction within 24 hours before revascularization were excluded.The study was limited to New York residents because the NewYork Vital Statistics Death File applies only to residents ofthe state. The study group comprised 37,212 patients who underwentCABG at the 34 hospitals in the state in which CABG was performedand 22,102 patients who underwent stenting at the 35 hospitalsin the state in which PCI was performed.
End points included death and death or revascularization (CABGor PCI) at any time before December 31, 2000. Subsequent revascularizationswere identified by matching patients' Social Security numberswith CABG and PCI procedures listed in CSRS and PCIRS.
Statistical Analysis
The primary purpose of the data analyses was to determine whetherlong-term mortality differed significantly between patientsundergoing CABG and those undergoing PCI, after controllingfor differences in patients' preprocedural risk. A secondarypurpose was to determine whether there were treatment-relateddifferences in long-term mortality among patients with diabetes,patients with compromised ventricular function (defined by aleft ventricular ejection fraction of less than 40 percent),and patients without compromised ventricular function. We plannedto accomplish this by first identifying factors that were associatedwith a risk of death in univariate analyses and then using amultivariate (Cox proportional-hazards) model that controlledfor significant risk factors while testing for significant differencesin long-term mortality between patients undergoing CABG andthose undergoing PCI. Because the number of diseased vessels,the presence or absence of involvement of the left anteriordescending coronary (LAD) artery, and the presence or absenceof disease in the proximal portion of the LAD artery are majorfactors in the determination of which procedure to perform,the analyses were performed separately for each of five anatomicalgroups among patients with two- or three-vessel disease (patientswith single-vessel disease were omitted because the vast majoritywho undergo revascularization do so by means of PCI).
We compared the prevalences of potential risk factors for eachprocedure using chi-square and Fisher's exact (for binary riskfactors) tests. Factors included the number of diseased vessels,the patient's age and sex, the presence or absence of a varietyof coexisting conditions, and measures of the patient's hemodynamicstate and ventricular function. Kaplan–Meier estimateswere used to plot the percentage of patients in each group whounderwent subsequent revascularization; data on patients whodied before subsequent revascularization were censored.
Each patient was placed in one of five anatomical groups accordingto whether two or three vessels were diseased, whether therewas clinically significant disease in the LAD artery, and ifthere was, whether it was in the proximal region. A backwardstepwise Cox model was used to identify risk factors in eachsubgroup that were significantly related to long-term mortality.A P value of less than 0.05 was used to indicate statisticalsignificance. The type of revascularization (CABG vs. PCI) wasthen added as an independent binary variable, with "1" denotingCABG.
For each of the five groups of patients, point estimates andconfidence intervals were calculated for hazard ratios.21 Also,unadjusted survival curves were generated for each interventionfor each anatomical group with the use of Kaplan–Meierestimates, and adjusted survival curves were generated withthe use of the Cox model in conjunction with methods describedby Ghali et al.22 The log-rank test was used to identify significantdifferences in unadjusted survival rates. As prespecified inthe protocol, survival rates in all anatomical subgroups wereevaluated to identify differences in the subgroups of patientswith diabetes, patients with compromised ventricular function,and those without such compromise.
Selection bias was examined with the use of a propensity model.23,24Covariates that were considered for inclusion in the modelsincluded all variables presented in Table 1. Variables thatwere significant predictors of the type of revascularizationwere identified by fitting a logistic-regression model witha binary dependent variable representing CABG. For each anatomicalgroup, the propensity score was subdivided into quintiles andhazard ratios were compared across quintiles. All analyses wereconducted with the use of SAS software (version 8.2), and allreported P values are two-sided.
Table 1. Baseline Characteristics of the Patients.
Results
The median follow-up was 706.0 days in the CABG group (interquartilerange, 328 to 1089) and 585.0 days in the stenting group (interquartilerange, 265 to 948). Patients who underwent CABG were significantlyolder than patients who received stents, although more patientsin the latter group were 80 years of age or older. Also, patientswho underwent CABG were more likely to be white men and lesslikely to be Hispanic. Patients who underwent CABG had significantlylower median ejection fractions and were less likely than patientswho received stents to have had a myocardial infarction in theweek before the procedure. Patients who underwent CABG alsohad a significantly higher prevalence of numerous coexistingconditions and were significantly more likely to have three-vesseldisease (Table 1).
In the stenting group, 7.8 percent underwent subsequent CABGand 27.3 percent underwent repeated PCI in the three years afterthe initial procedure. Also, 0.3 percent of the CABG group underwentCABG and 4.6 percent underwent PCI in the ensuing three-yearperiod (Figure 1). The overall rates of revascularization weresignificantly lower in the CABG group than in the stenting group(P<0.001).
Figure 1. Percentage of Patients Undergoing a Second Revascularization Procedure within Three Years.
The observed (unadjusted) in-hospital mortality rate among thepatients in the CABG group was significantly higher than therate among patients who received a stent (1.75 percent [650deaths] vs. 0.68 percent [150 deaths], P<0.001). The respectiveadjusted hazard ratios ranged from 0.76 (P=0.02) for patientswith two-vessel disease and involvement of the nonproximal LADartery to 0.64 (P<0.001) for patients with three-vessel diseaseand involvement of the proximal LAD artery (Table 2). Significantrisk factors in the statistical models included a lower ejectionfraction; the presence of diabetes, congestive heart failure,chronic obstructive pulmonary disease, carotid-artery disease,aortoiliac disease, shock, renal failure, femoral or poplitealdisease, and stroke; advanced age; and male sex. Figure 2 presentsunadjusted survival curves and Figure 3 presents adjusted survivalcurves for three of the anatomical groups. For the unadjustedcurves, the survival rate was significantly higher after stentplacement than after CABG among patients who had two-vesseldisease without involvement of the LAD artery (P=0.03), whereasthe opposite was true among patients who had three-vessel diseasewith involvement of the proximal LAD artery (P<0.001); therewere no significant treatment-related differences in survivalin the other anatomical groups.
Figure 2. Unadjusted Kaplan–Meier Survival Curves among Patients with Two-Vessel Disease without Involvement of the LAD Artery (Panel A), Patients with Two-Vessel Disease with Involvement of the Proximal LAD Artery (Panel B), and Patients with Three-Vessel Disease with Involvement of the Proximal LAD Artery (Panel C).
Values are percentages at one, two, and three years.
Figure 3. Adjusted Survival Curves among Patients with Two-Vessel Disease without Involvement of the LAD Artery (Panel A), Patients with Two-Vessel Disease with Involvement of the Proximal LAD Artery (Panel B), and Patients with Three-Vessel Disease with Involvement of the Proximal LAD Artery (Panel C).
Values are percentages at one, two, and three years; they were adjusted for the ejection fraction; the presence or absence of diabetes, congestive heart failure, chronic obstructive pulmonary disease, carotid-artery disease, aortoiliac disease, shock, renal failure, femoral or popliteal disease, and stroke; age; and sex.
After adjustment for the severity of illness before revascularization,CABG was associated with a significantly higher likelihood ofsurvival in all anatomical groups, as indicated in Table 2.The finding that unadjusted survival estimates favored PCI andadjusted survival estimates favored CABG for patients with two-vesseldisease without LAD-artery involvement can be explained by thefact that the prevalences of several important risk factorswere much higher in the CABG group than in the stenting group(e.g., 3.4 percent vs. 2.2 percent for renal failure, 16.4 percentvs. 5.9 percent for chronic obstructive pulmonary disease, and12.3 percent vs. 7.0 percent for congestive heart failure).
When the subgroup of patients with diabetes was analyzed, theadjusted hazard ratios were lower after CABG than after stentingin all anatomical subgroups except patients who had three-vesseldisease with involvement of the proximal LAD artery (0.69; 95percent confidence interval, 0.55 to 0.86). For patients witha left ventricular ejection fraction below 40 percent, the hazardratios were significantly in favor of CABG, as compared withstenting, for patients with three-vessel disease and patientswith two-vessel disease with involvement of the proximal LADartery, but the hazard ratios were not significant for the otherpatients with two-vessel disease. For patients with no leftventricular dysfunction (as defined by an ejection fractionof at least 40 percent), CABG was associated with significantlylower adjusted hazard ratios in all anatomical groups (Table 2).
The majority of patients with two-vessel disease underwent stenting,whereas the majority of patients with three-vessel disease underwentCABG. For example, 90.6 percent of patients who had three-vesseldisease with involvement of the proximal LAD artery underwentCABG, and patients in this group who underwent stent implantationwere more likely than patients who underwent CABG to be in shock(0.4 percent vs. 0.2 percent) or to have received cardiopulmonaryresuscitation (0.2 percent vs. 0.04 percent).
In the propensity analyses, significant covariates includedage, sex, race, left ventricular ejection fraction, and presenceor absence of a previous myocardial infarction and a varietyof coexisting conditions, including diabetes, chronic obstructivepulmonary disease, carotid disease, femoral or popliteal disease,and renal failure with a need for dialysis. Distributions ofpatients who underwent CABG ranged from about 10 percent to40 percent across quintiles for the anatomical groups with two-vesseldisease and no disease of the proximal LAD artery, from 82 percentto 97 percent for patients who had three-vessel disease withdisease of the proximal LAD artery, and from about 45 percentto 85 percent for the other two groups of patients with multivesseldisease. Hazard ratios consistently favored CABG surgery overstent implantation, with 22 of the 25 anatomical-subgroup quintileshaving hazard ratios between 0.44 and 0.84.
Discussion
Our observational study, which included 37,212 patients whounderwent CABG and 22,102 patients who underwent stenting, foundthat the adjusted hazard ratios for the long-term risk of deathafter CABG relative to stent implantation ranged from 0.76 (95percent confidence interval, 0.60 to 0.96) for patients withtwo-vessel disease with involvement of the nonproximal LAD arteryto 0.64 (95 percent confidence interval, 0.56 to 0.74) for three-vesseldisease with involvement of the proximal LAD artery. Also, revascularizationrates were considerably higher after stenting than after CABG(7.8 percent vs. 0.3 percent for subsequent CABG surgery and27.3 percent vs. 4.6 percent for subsequent PCI).
Most randomized, controlled trials predating the stenting erathat compared CABG with PCI did not find significant differencesin long-term mortality between the two interventions. This findingmay have been due in part to insufficient statistical power.For example, in the Bypass Angioplasty Revascularization Investigationstudy, the five-year mortality rate was 10.7 percent after CABG,as compared with 13.7 percent after PCI, but this differencewas not significant (P=0.19), at least partially because ofthe relatively small numbers of patients in the study (914 and915, respectively).5 A meta-analysis of randomized, controlledtrials that compared CABG with PCI found that for patients withmultivessel disease, CABG provided survival advantages of 2.3percent (P=0.03) at five years and 3.4 percent (P=0.03) at eightyears.19
Prior information on relative long-term outcomes for CABG andstent implantation has been limited to four randomized, controlledtrials with relatively small numbers of patients (123 to 1205patients in each study).8,11,13,15 During follow-up periodsranging from one to three years, one of these studies foundsignificantly lower mortality rates after CABG,8 one found significantlyhigher mortality rates after CABG,13 and the other two, oneof which included patients with single-vessel disease, foundno significant difference in mortality rates between the twointerventions.11,15 A meta-analysis of these studies found nosignificant differences in one-year or three-year mortalityrates between the two interventions19 but did find that patientswho underwent CABG had significantly fewer subsequent revascularizations(15 percent fewer at one year and 15 percent fewer at threeyears) than patients who underwent stenting.19 As evidencedby the small numbers of patients in the studies of long-termsurvival after stenting, as compared with CABG, very littleinformation is currently available from randomized, controlledtrials.
A caveat of our study is that it is observational, and not arandomized, controlled trial. As such, the choice of treatmentwas left to the physician, and one of the treatment optionsmay have been contraindicated in some patients. Also, the analysisof survival does not include patients who died before they couldundergo one of the scheduled revascularization procedures. Consequently,if there is a longer wait for one of the procedures and thisresults in additional adverse outcomes, this fact would nothave been reflected by our findings.
We attempted to minimize the selection bias by adjusting fordifferences among patients in demographic characteristics, coexistingconditions, ventricular function, and hemodynamic state. Furthermore,propensity analyses demonstrated that the survival advantagefor CABG persisted regardless of the chance of patients' beingreferred for stent implantation rather than CABG. In addition,comprehensive studies that have compared the results of randomized,controlled trials and observational studies in assessing twocompeting interventions have concluded that the treatment effectsare not qualitatively different and that the observational studiesdo not overestimate the magnitude of the treatment effects.25,26Nevertheless, there remains the possibility that observationalstudies may fail to identify all confounders, and it is alsotrue that propensity analyses cannot account for selection biasrelated to unmeasured characteristics.
Another important caveat is that although this study is basedon data as recent as those used by any other study comparingthese two interventions, the state of the art for both treatmentsis rapidly changing. The most notable of these changes is probablythe availability of drug-eluting stents, but the use of CABGwithout cardiopulmonary bypass and cardiac arrest ("off pump")has also become much more common in the past few years and isunderrepresented in our study. In particular, future studieswill be needed to compare long-term outcomes for drug-elutingstents with those for CABG in patients with various types ofrisk factors before the procedure.27,28,29
There are many considerations when one is choosing an interventionfor patients with ischemic heart disease. Stenting is far lessinvasive than CABG, and many patients may prefer to have oneor more stents implanted in the hope of avoiding CABG. As notedearlier, stent implantation has a much lower in-hospital mortalityrate than CABG. Depending on the patient's life expectancy andattitude about the relative merits of short-term and long-termrisk, stent implantation may be preferred even for a patientin an anatomical group for which CABG has significantly higherrisk-adjusted long-term survival. Howard et al. provide an excellentcomprehensive discussion of these trade-offs.30
As with our earlier comparison of CABG with PCI in the infancyof stent implantation,16 we restricted ourselves to the studyof New York State residents because we were unable to determinewhen patients who lived in other states died after discharge.However, we had no way of knowing whether our patients movedto another state and died there or underwent revascularizationthere, since we used only the New York State death file. Nevertheless,we do not believe that any bias was introduced by this limitation,because we would expect roughly the same percentage of patientsin each intervention group to be lost to follow-up.16
We are indebted to Kenneth Shine, M.D., the chair of New YorkState's Cardiac Advisory Committee, and to the other membersof the committee for their encouragement and support of thisstudy; and to Paula Wauselauskas, Casey Joseph, Kimberly S.Cozzens, Rosemary Lombardo, and the cardiac-surgery departmentsand cardiac-catheterization laboratories of the 35 participatinghospitals for their tireless efforts to ensure the timeliness,completeness, and accuracy of the registry data.
Source Information
From the University at Albany, State University of New York, Albany (E.L.H., M.J.R.); St. Joseph's Hospital, Syracuse, N.Y. (G.W.); Duke University Medical Center, Durham, N.C. (R.H.J.); Boston University School of Medicine, Boston (T.J.R.); St. Peter's Hospital, Albany, N.Y. (E.B.); New York University Medical Center, New York (A.T.C.); New York Hospital–Weill Cornell Medical Center, New York (O.W.I.); Montefiore Medical Center, Bronx, N.Y. (J.P.G.); and Columbia–Presbyterian Medical Center, New York (E.A.R.).
References
Coronary angioplasty versus coronary artery bypass surgery: the Randomized Intervention Treatment of Angina (RITA) trial. Lancet 1993;341:573-580. [CrossRef][ISI][Medline]
King SB III, Kosinski AS, Guyton RA, Lembo NJ, Weintraub WS. Eight-year mortality in the Emory Angioplasty versus Surgery Trial (EAST). J Am Coll Cardiol 2000;35:1116-1121. [Free Full Text]
King SB III, Lembo NJ, Weintraub WS, et al. A randomized trial comparing coronary angioplasty with coronary bypass surgery. N Engl J Med 1994;331:1044-1050. [Free Full Text]
Hamm CW, Reimers J, Ischinger T, Rupprecht HJ, Berger J, Bleifeld W. A randomized study of coronary angioplasty compared with bypass surgery in patients with symptomatic multivessel coronary disease. N Engl J Med 1994;331:1037-1043. [Free Full Text]
The Bypass Angioplasty Revascularization Investigation (BARI) Investigators. Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. N Engl J Med 1996;335:217-225. [Erratum, N Engl J Med 1997;336:147.] [Free Full Text]
Chaitman BR, Rosen AD, Williams DO, et al. Myocardial infarction and cardiac mortality in the Bypass Angioplasty Revascularization Investigation (BARI) randomized trial. Circulation 1997;96:2162-2170. [Free Full Text]
First-year results of CABRI (Coronary Angioplasty versus Bypass Revascularisation Investigation). Lancet 1995;346:1179-1184. [CrossRef][ISI][Medline]
SoS Investigators. Coronary artery bypass surgery versus percutaneous coronary intervention with stent implantation in patients with multivessel coronary artery disease (the Stent or Surgery trial): a randomised controlled trial. Lancet 2002;360:965-970. [CrossRef][ISI][Medline]
Carrie D, Elbaz M, Puel J, et al. Five-year outcome after coronary angioplasty versus bypass surgery in multivessel coronary artery disease: results from the French Monocentric Study. Circulation 1997;96:Suppl 9:II-1.
Goy JJ, Eeckhout E, Burnand B, et al. Coronary angioplasty versus left internal mammary artery grafting for isolated proximal left anterior descending artery stenosis. Lancet 1994;343:1449-1453. [CrossRef][ISI][Medline]
Goy JJ, Kaufmann U, Goy-Eggenberger D, et al. A prospective randomized trial comparing stenting to internal mammary artery grafting for proximal, isolated de novo left anterior coronary artery stenosis: the SIMA trial. Mayo Clin Proc 2000;75:1116-1123. [ISI][Medline]
Hueb WA, Soares PR, Almeida De Oliveira S, et al. Five-year follow-up of the Medicine, Angioplasty, or Surgery Study (MASS): a prospective, randomized trial of medical therapy, balloon angioplasty, or bypass surgery for single proximal left anterior descending coronary artery stenosis. Circulation 1999;100:Suppl 19:II-107.
Rodriguez A, Bernardi V, Navia J, et al. Argentine randomized study: coronary angioplasty with stenting versus coronary bypass surgery in patients with multiple-vessel disease (ERACI II): 30-day and one-year follow-up results. J Am Coll Cardiol 2001;37:51-58. [Erratum, J Am Coll Cardiol 2001;37:973-4.] [Free Full Text]
Rodriguez A, Boullon F, Perez-Balino N, Paviotti C, Liprandi MI, Palacios IF. Argentine randomized trial of percutaneous transluminal coronary angioplasty versus coronary artery bypass surgery in multivessel disease (ERACI): in-hospital results and 1-year follow-up. J Am Coll Cardiol 1993;22:1060-1067. [Abstract]
Serruys PW, Unger F, Sousa JE, et al. Comparison of coronary-artery bypass surgery and stenting for the treatment of multivessel disease. N Engl J Med 2001;344:1117-1124. [Free Full Text]
Hannan EL, Racz MJ, McCallister BD, et al. A comparison of three-year survival after coronary artery bypass graft surgery and percutaneous transluminal coronary angioplasty. J Am Coll Cardiol 1999;33:63-72. [Free Full Text]
Jones RH, Kesler K, Phillips HR III, et al. Long-term survival benefits of coronary artery bypass grafting and percutaneous transluminal angioplasty in patients with coronary artery disease. J Thorac Cardiovasc Surg 1996;111:1013-1025. [Free Full Text]
Mark DB, Nelson CL, Califf RM, et al. Continuing evolution of therapy for coronary artery disease: initial results from the era of coronary angioplasty. Circulation 1994;89:2015-2025. [Free Full Text]
Hoffman SN, TenBrook JA, Wolf MP, Pauker SG, Salem DN, Wong JB. A meta-analysis of randomized controlled trials comparing coronary artery bypass graft with percutaneous transluminal coronary angioplasty: one- to eight-year outcomes. J Am Coll Cardiol 2003;41:1293-1304. [Free Full Text]
Lauer MS, Topol EJ. Clinical trials -- multiple treatments, multiple end points, and multiple lessons. JAMA 2003;289:2575-2577. [Free Full Text]
Allison P. Survival analysis using the SAS system. Cary, N.C.: SAS Institute, 1995.
Ghali WA, Quan H, Brant R, et al. Comparison of two methods for calculating adjusted survival curves from proportional hazards. JAMA 2001;286:1494-1497. [Free Full Text]
Rosenbaum PR, Rubin DB. Reducing bias in observational studies using subclassification on the propensity score. J Am Stat Assoc 1984;79:516-524. [CrossRef][ISI]
Rosenbaum PR, Rubin DB. The central role of the propensity score in observational studies for causal effects. Biometrika 1983;70:41-55. [Free Full Text]
Benson K, Hartz AJ. A comparison of observational studies and randomized, controlled trials. N Engl J Med 2000;342:1878-1886. [Free Full Text]
Concato J, Shah N, Horwitz RI. Randomized, controlled trials, observational studies, and the hierarchy of research designs. N Engl J Med 2000;342:1887-1892. [Free Full Text]
Regar E, Serruys PW, Bode C, et al. Angiographic findings of the multicenter Randomized Study With the Sirolimus-Eluting BX Velocity Balloon-Expandable Stent (RAVEL): sirolimus-eluting stents inhibit restenosis irrespective of the vessel size. Circulation 2002;106:1949-1956. [Free Full Text]
Moses JW, Leon MB, Popma JJ, et al. Sirolimus-eluting stents versus standard stents in patients with stenosis in a native coronary artery. N Engl J Med 2003;349:1315-1323. [Free Full Text]
Tanabe K, Serruys PW, Grube E, et al. TAXUS III Trial: in-stent restenosis treated with stent-based delivery of paclitaxel incorporated in a slow-release polymer formulation. Circulation 2003;107:559-564. [Free Full Text]
Howard G, Chambless LE, Kronmal RA. Assessing differences in clinical trials comparing surgical vs nonsurgical therapy: using common (statistical) sense. JAMA 1997;278:1432-1436. [Erratum, JAMA 1998;279:580.] [Abstract]
Kimura, T., Morimoto, T., Furukawa, Y., Nakagawa, Y., Shizuta, S., Ehara, N., Taniguchi, R., Doi, T., Nishiyama, K., Ozasa, N., Saito, N., Hoshino, K., Mitsuoka, H., Abe, M., Toma, M., Tamura, T., Haruna, Y., Imai, Y., Teramukai, S., Fukushima, M., Kita, T.
(2008). Long-Term Outcomes of Coronary-Artery Bypass Graft Surgery Versus Percutaneous Coronary Intervention for Multivessel Coronary Artery Disease in the Bare-Metal Stent Era. Circulation
118: S199-S209
[Abstract][Full Text]
Daemen, J., Boersma, E., Flather, M., Booth, J., Stables, R., Rodriguez, A., Rodriguez-Granillo, G., Hueb, W. A., Lemos, P. A., Serruys, P. W.
(2008). Long-Term Safety and Efficacy of Percutaneous Coronary Intervention With Stenting and Coronary Artery Bypass Surgery for Multivessel Coronary Artery Disease: A Meta-Analysis With 5-Year Patient-Level Data From the ARTS, ERACI-II, MASS-II, and SoS Trials. Circulation
118: 1146-1154
[Abstract][Full Text]
Mack, M. J., Prince, S. L., Herbert, M., Brown, P. P., Katz, M., Palmer, G., Edgerton, J. R., Eichhorn, E., Magee, M. J., Dewey, T. M.
(2008). Current clinical outcomes of percutaneous coronary intervention and coronary artery bypass grafting.. Ann. Thorac. Surg.
86: 496-503
[Abstract][Full Text]
Rastan, A. J., Boudriot, E., Falk, V., Kappetein, A. P., Borger, M. A., Serruys, P. W., Schuler, G., Mohr, F. W.
(2008). Frequency and pattern of de-novo three-vessel and left main coronary artery disease; insights from single center enrolment in the SYNTAX study. Eur. J. Cardiothorac. Surg.
34: 376-383
[Abstract][Full Text]
Kohsaka, S., Goto, M., Virani, S., Lee, V.-V., Aoki, N., Elayda, M. A., Reul, R. M., Wilson, J. M.
(2008). Long-term clinical outcome of coronary artery stenting or coronary artery bypass grafting in patients with multiple-vessel disease.. J. Thorac. Cardiovasc. Surg.
136: 500-506
[Abstract][Full Text]
Holmes, D. R. Jr, Williams, D. O.
(2008). Catheter-Based Treatment of Coronary Artery Disease: Past, Present, and Future. Circ Cardiovasc Intervent
1: 60-73
[Abstract][Full Text]
Daemen, J., Kukreja, N., Serruys, P. W., Abbate, A., Lipinski, M. J., Harjai, K. J., Ng, A. C.C., Kritharides, L., Burack, J. H., Hannan, E. L.
(2008). Drug-Eluting Stents vs. Coronary-Artery Bypass Grafting. NEJM
358: 2641-2644
[Full Text]
Hannan, E. L.
(2008). Randomized Clinical Trials and Observational Studies: Guidelines for Assessing Respective Strengths and Limitations. J Am Coll Cardiol Intv
1: 211-217
[Abstract][Full Text]
Lytle, B. W.
(2008). The Challenge of Left Main Stenosis. J Am Coll Cardiol Intv
1: 246-247
[Full Text]
Ortiz-Perez, J. T., Rodriguez, J., Meyers, S. N., Lee, D. C., Davidson, C., Wu, E.
(2008). Correspondence Between the 17-Segment Model and Coronary Arterial Anatomy Using Contrast-Enhanced Cardiac Magnetic Resonance Imaging. J Am Coll Cardiol Img
1: 282-293
[Abstract][Full Text]
Park, D.-W., Yun, S.-C., Lee, S.-W., Kim, Y.-H., Lee, C. W., Hong, M.-K., Kim, J.-J., Choo, S. J., Song, H., Chung, C. H., Lee, J.-W., Park, S.-W., Park, S.-J.
(2008). Long-Term Mortality After Percutaneous Coronary Intervention With Drug-Eluting Stent Implantation Versus Coronary Artery Bypass Surgery for the Treatment of Multivessel Coronary Artery Disease. Circulation
117: 2079-2086
[Abstract][Full Text]
Doenst, T., Borger, M. A., Weisel, R. D., Yau, T. M., Maganti, M., Rao, V.
(2008). Relation between aortic cross-clamp time and mortality -- not as straightforward as expected. Eur. J. Cardiothorac. Surg.
33: 660-665
[Abstract][Full Text]
Taggart, D. P., Kaul, S., Boden, W. E., Ferguson, T. B. Jr, Guyton, R. A., Mack, M. J., Sergeant, P. T., Shemin, R. J., Smith, P. K., Yusuf, S.
(2008). Revascularization for unprotected left main stem coronary artery stenosis stenting or surgery.. J Am Coll Cardiol
51: 885-892
[Abstract][Full Text]
Brinker, J.
(2008). The left main facts: faced, spun, but alas too few.. J Am Coll Cardiol
51: 893-898
[Abstract][Full Text]
Taggart, D. P.
(2008). Does prior PCI increase the risk of subsequent CABG?. Eur Heart J
29: 573-575
[Full Text]
Shuhaiber, J., Reston, J.
(2008). Time to Intervention During Cardiac Interventions. Are We Forgetting a Confounder?. Asian Cardiovasc. Thorac. Ann.
16: 1-3
[Full Text]
Rao, C., Stanbridge, R. D. L., Chikwe, J., Pepper, J., Skapinakis, P., Aziz, O., Darzi, A., Athanasiou, T.
(2008). Does Previous Percutaneous Coronary Stenting Compromise the Long-Term Efficacy of Subsequent Coronary Artery Bypass Surgery? A Microsimulation Study. Ann. Thorac. Surg.
85: 501-507
[Abstract][Full Text]
Hannan, E. L., Wu, C., Walford, G., Culliford, A. T., Gold, J. P., Smith, C. R., Higgins, R. S.D., Carlson, R. E., Jones, R. H.
(2008). Drug-Eluting Stents vs. Coronary-Artery Bypass Grafting in Multivessel Coronary Disease. NEJM
358: 331-341
[Abstract][Full Text]
Carrozza, J. P. Jr.
(2008). Drug-Eluting Stents -- Pushing the Envelope beyond the Labels?. NEJM
358: 405-407
[Full Text]
Ferguson, T. B. Jr
(2008). On the Evaluation of Intervention Outcome Risks for Patients With Ischemic Heart Disease. Circulation
117: 333-335
[Full Text]
Desai, N. D.
(2008). Pitfalls Assessing the Role of Drug-Eluting Stents in Multivessel Coronary Disease. Ann. Thorac. Surg.
85: 25-27
[Full Text]
DiGiorgi, P. L., Baumann, F. G., O'Leary, A. M., Schwartz, C. F., Grossi, E. A., Ribakove, G. H., Colvin, S. B., Galloway, A. C., Grau, J. B.
(2008). Mitral Valve Disease Presentation and Surgical Outcome in African-American Patients Compared With White Patients. Ann. Thorac. Surg.
85: 89-93
[Abstract][Full Text]
Brown, M. L., Sundt, T. M. III, Gersh, B. J.
(2008). Indications for Revascularization. Card Surg Adult
3: 551-572
[Full Text]
Gongora, E., Sundt, T. M. III
(2008). Myocardial Revascularization with Cardiopulmonary Bypass. Card Surg Adult
3: 599-632
[Full Text]
George, I., Oz, M. C.
(2008). Myocardial Revascularization after Acute Myocardial Infarction. Card Surg Adult
3: 669-696
[Full Text]
Rouleau, J. L., Warnica, W. J., Baillot, R., Block, P. J., Chocron, S., Johnstone, D., Myers, M. G., Calciu, C.-D., Dalle-Ave, S., Martineau, P., Mormont, C., van Gilst, W. H., for the IMAGINE (Ischemia Management with Accupril,
(2008). Effects of Angiotensin-Converting Enzyme Inhibition in Low-Risk Patients Early After Coronary Artery Bypass Surgery. Circulation
117: 24-31
[Abstract][Full Text]
Dacey, L. J., Likosky, D. S., Ryan, T. J. Jr, Robb, J. F., Quinn, R. D., DeVries, J. T., Hearne, M. J., Leavitt, B. J., Dunton, R. F., Clough, R. A., Sisto, D., Ross, C. S., Olmstead, E. M., O'Connor, G. T., Malenka, D. J., Northern New England Cardiovascular Disease Study,
(2007). Long-Term Survival After Surgery Versus Percutaneous Intervention in Octogenarians With Multivessel Coronary Disease. Ann. Thorac. Surg.
84: 1904-1911
[Abstract][Full Text]
Bravata, D. M., Gienger, A. L., McDonald, K. M., Sundaram, V., Perez, M. V., Varghese, R., Kapoor, J. R., Ardehali, R., Owens, D. K., Hlatky, M. A.
(2007). Systematic Review: The Comparative Effectiveness of Percutaneous Coronary Interventions and Coronary Artery Bypass Graft Surgery. ANN INTERN MED
147: 703-716
[Abstract][Full Text]
Gershlick, T., Thomas, M.
(2007). PCI or CABG: which patients and at what cost?. Heart
93: 1188-1190
[Full Text]
Gerber, Y., Rihal, C. S., Sundt, T. M. III, Killian, J. M., Weston, S. A., Therneau, T. M., Roger, V. L.
(2007). Coronary Revascularization in the Community: A Population-Based Study, 1990 to 2004. J Am Coll Cardiol
50: 1223-1229
[Abstract][Full Text]
Choudhary, B. P., Antoniades, C., Brading, A. F., Galione, A., Channon, K., Taggart, D. P.
(2007). Diabetes Mellitus as a Predictor for Radial Artery Vasoreactivity in Patients Undergoing Coronary Artery Bypass Grafting. J Am Coll Cardiol
50: 1047-1053
[Abstract][Full Text]
Javaid, A., Steinberg, D. H., Buch, A. N., Corso, P. J., Boyce, S. W., Pinto Slottow, T. L., Roy, P. K., Hill, P., Okabe, T., Torguson, R., Smith, K. A., Xue, Z., Gevorkian, N., Suddath, W. O., Kent, K. M., Satler, L. F., Pichard, A. D., Waksman, R.
(2007). Outcomes of Coronary Artery Bypass Grafting Versus Percutaneous Coronary Intervention With Drug-Eluting Stents for Patients With Multivessel Coronary Artery Disease. Circulation
116: I-200-I-206
[Abstract][Full Text]
Bair, T. L., Muhlestein, J. B., May, H. T., Meredith, K. G., Horne, B. D., Pearson, R. R., Li, Q., Jensen, K. R., Anderson, J. L., Lappe, D. L.
(2007). Surgical Revascularization Is Associated With Improved Long-Term Outcomes Compared With Percutaneous Stenting in Most Subgroups of Patients With Multivessel Coronary Artery Disease: Results From the Intermountain Heart Registry. Circulation
116: I-226-I-231
[Abstract][Full Text]
Ward, M. R, Bridgewater, B.
(2007). Implications of publishing surgical results. Heart
93: 1136-1136
[Full Text]
Anderson, J. L., Adams, C. D., Antman, E. M., Bridges, C. R., Califf, R. M., Casey, D. E. Jr, Chavey, W. E. II, Fesmire, F. M., Hochman, J. S., Levin, T. N., Lincoff, A. M., Peterson, E. D., Theroux, P., Wenger, N. K., Wright, R. S., Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Halperin, J. L., Hunt, S. A., Krumholz, H. M., Kushner, F. G., Lytle, B. W., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B.
(2007). ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non-ST-Elevation Myocardial Infarction) Developed in Collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol
50: e1-e157
[Full Text]
Anderson, J. L., Adams, C. D., Antman, E. M., Bridges, C. R., Califf, R. M., Casey, D. E. Jr, Chavey, W. E. II, Fesmire, F. M., Hochman, J. S., Levin, T. N., Lincoff, A. M., Peterson, E. D., Theroux, P., Wenger, N. K., Wright, R. S., Smith, S. C. Jr, Jacobs, A. K., Adams, C. D., Anderson, J. L., Antman, E. M., Halperin, J. L., Hunt, S. A., Krumholz, H. M., Kushner, F. G., Lytle, B. W., Nishimura, R., Ornato, J. P., Page, R. L., Riegel, B.
(2007). ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non ST-Elevation Myocardial Infarction Executive Summary: A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Revise the 2002 Guidelines for the Management of Patients With Unstable Angina/Non ST-Elevation Myocardial Infarction) Developed in Collaboration with the American College of Emergency Physicians, the Society for Cardiovascular Angiography and Interventions, and the Society of Thoracic Surgeons Endorsed by the American Association of Cardiovascular and Pulmonary Rehabilitation and the Society for Academic Emergency Medicine. J Am Coll Cardiol
50: 652-726
[Full Text]
Thielmann, M., Neuhauser, M., Knipp, S., Kottenberg-Assenmacher, E., Marr, A., Pizanis, N., Hartmann, M., Kamler, M., Massoudy, P., Jakob, H.
(2007). Prognostic impact of previous percutaneous coronary intervention in patients with diabetes mellitus and triple-vessel disease undergoing coronary artery bypass surgery. J. Thorac. Cardiovasc. Surg.
134: 470-476
[Abstract][Full Text]
Glance, L. G., Osler, T. M., Mukamel, D. B., Dick, A. W.
(2007). Effect of complications on mortality after coronary artery bypass grafting surgery: Evidence from New York State. J. Thorac. Cardiovasc. Surg.
134: 53-58
[Abstract][Full Text]
Wong, S. H, Wan, S., Underwood, M. J
(2007). Myocardial Revascularization: Surgery or Stenting?. Asian Cardiovasc. Thorac. Ann.
15: 264-269
[Abstract][Full Text]
Authors/Task Force Members, , Ryden, L., Standl, E., Bartnik, M., Berghe, G. V. d., Betteridge, J., de Boer, M.-J., Cosentino, F., Jonsson, B., Laakso, M., Malmberg, K., Priori, S., Ostergren, J., Tuomilehto, J., Thrainsdottir, I., Other Contributors, , Vanhorebeek, I., Stramba-Badiale, M., Lindgren, P., Qiao, Q., ESC Committee for Practice Guidelines (CPG), , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, J., Dean, V., Deckers, J., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J., Zamorano, J. L., Document Reviewers, , Deckers, J. W., Bertrand, M., Charbonnel, B., Erdmann, E., Ferrannini, E., Flyvbjerg, A., Gohlke, H., Juanatey, J. R. G., Graham, I., Monteiro, P. F., Parhofer, K., Pyorala, K., Raz, I., Schernthaner, G., Volpe, M., Wood, D.
(2007). Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: full text: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J Suppl
9: C3-C74
[Full Text]
The BARI Investigators,
(2007). The Final 10-Year Follow-Up Results From the BARI Randomized Trial. J Am Coll Cardiol
49: 1600-1606
[Abstract][Full Text]
Taggart, D. P
(2007). Coronary revascularisation. BMJ
334: 593-594
[Full Text]
Bainbridge, D., Cheng, D., Martin, J., Novick, R., The Evidence-based Peri-operative Clinical Outcome,
(2007). Does off-pump or minimally invasive coronary artery bypass reduce mortality, morbidity, and resource utilization when compared with percutaneous coronary intervention? A meta-analysis of randomized trials. J. Thorac. Cardiovasc. Surg.
133: 623-631
[Abstract][Full Text]
Rankin, J. S., Tuttle, R. H., Wechsler, A. S., Teichmann, T. L., Glower, D. D., Califf, R. M.
(2007). Techniques and Benefits of Multiple Internal Mammary Artery Bypass at 20 Years of Follow-Up. Ann. Thorac. Surg.
83: 1008-1015
[Abstract][Full Text]
Authors/Task Force Members, , Ryden, L., Standl, E., Bartnik, M., Van den Berghe, G., Betteridge, J., de Boer, M.-J., Cosentino, F., Jonsson, B., Laakso, M., Malmberg, K., Priori, S., Ostergren, J., Tuomilehto, J., Thrainsdottir, I., Other Contributors, , Vanhorebeek, I., Stramba-Badiale, M., Lindgren, P., Qiao, Q., ESC Committee for Practice Guidelines (CPG), , Priori, S. G., Blanc, J.-J., Budaj, A., Camm, J., Dean, V., Deckers, J., Dickstein, K., Lekakis, J., McGregor, K., Metra, M., Morais, J., Osterspey, A., Tamargo, J., Zamorano, J. L., Document Reviewers, , Deckers, J. W., Bertrand, M., Charbonnel, B., Erdmann, E., Ferrannini, E., Flyvbjerg, A., Gohlke, H., Juanatey, J. R. G., Graham, I., Monteiro, P. F., Parhofer, K., Pyorala, K., Raz, I., Schernthaner, G., Volpe, M., Wood, D.
(2007). Guidelines on diabetes, pre-diabetes, and cardiovascular diseases: executive summary: The Task Force on Diabetes and Cardiovascular Diseases of the European Society of Cardiology (ESC) and of the European Association for the Study of Diabetes (EASD). Eur Heart J
28: 88-136
[Full Text]
Cowper, P. A., DeLong, E. R., Hannan, E. L., Muhlbaier, L. H., Lytle, B. L., Jones, R. H., Holman, W. L., Pokorny, J. J., Stafford, J. A., Mark, D. B., Peterson, E. D.
(2007). Is Early Too Early? Effect of Shorter Stays After Bypass Surgery. Ann. Thorac. Surg.
83: 100-107
[Abstract][Full Text]
Dzwonczyk, R., Rio, C. L. d., Sai-Sudhakar, C., Sirak, J. H., Michler, R. E., Sun, B., Kelbick, N., Howie, M. B.
(2006). Vacuum-assisted apical suction devices induce passive electrical changes consistent with myocardial ischemia during off-pump coronary artery bypass graft surgery. Eur. J. Cardiothorac. Surg.
30: 873-876
[Abstract][Full Text]
Taggart, D. P.
(2006). Coronary Artery Bypass Grafting is Still the Best Treatment for Multivessel and Left Main Disease, But Patients Need to Know. Ann. Thorac. Surg.
82: 1966-1975
[Full Text]
Holmes, D. R. Jr, Moses, J. W., Schofer, J., Morice, M.-C., Schampaert, E., Leon, M. B.
(2006). Cause of death with bare metal and sirolimus-eluting stents. Eur Heart J
27: 2815-2822
[Abstract][Full Text]
Smith, P. K., Califf, R. M., Tuttle, R. H., Shaw, L. K., Lee, K. L., Delong, E. R., Lilly, R. E., Sketch, M. H. Jr, Peterson, E. D., Jones, R. H.
(2006). Selection of surgical or percutaneous coronary intervention provides differential longevity benefit.. Ann. Thorac. Surg.
82: 1420-1429
[Abstract][Full Text]
Barner, H. B.
(2006). Status of percutaneous coronary intervention and coronary artery bypass.. Eur. J. Cardiothorac. Surg.
30: 419-424
[Abstract][Full Text]
Cohn, L. H.
(2006). Evidence-based cardiac surgery. J. Thorac. Cardiovasc. Surg.
132: 457-458
[Full Text]
Levitsky, S.
(2006). Protecting the Myocardial Cell During Coronary Revascularization. Circulation
114: I-339-I-343
[Abstract][Full Text]
Soares, P. R., Hueb, W. A., Lemos, P. A., Lopes, N., Martinez, E. E., Cesar, L. A.M., Oliveira, S. A., Ramires, J. A.F.
(2006). Coronary Revascularization (Surgical or Percutaneous) Decreases Mortality After the First Year in Diabetic Subjects but not in Nondiabetic Subjects With Multivessel Disease: An Analysis From the Medicine, Angioplasty, or Surgery Study (MASS II). Circulation
114: I-420-I-424
[Abstract][Full Text]
Thielmann, M., Leyh, R., Massoudy, P., Neuhauser, M., Aleksic, I., Kamler, M., Herold, U., Piotrowski, J., Jakob, H.
(2006). Prognostic Significance of Multiple Previous Percutaneous Coronary Interventions in Patients Undergoing Elective Coronary Artery Bypass Surgery. Circulation
114: I-441-I-447
[Abstract][Full Text]
Grapow, M. T.R., von Wattenwyl, R., Guller, U., Beyersdorf, F., Zerkowski, H.-R.
(2006). Randomized controlled trials do not reflect reality: Real-world analyses are critical for treatment guidelines!. J. Thorac. Cardiovasc. Surg.
132: 5-7
[Full Text]
Ferguson, T. B. Jr
(2006). The "scientific investment" by cardiac surgery. J. Thorac. Cardiovasc. Surg.
132: 8-9
[Full Text]
Guyton, R. A.
(2006). Coronary Artery Bypass is Superior to Drug-Eluting Stents in Multivessel Coronary Artery Disease. Ann. Thorac. Surg.
81: 1949-1957
[Abstract][Full Text]
Hannan, E. L., Racz, M., Holmes, D. R., King, S. B. III, Walford, G., Ambrose, J. A., Sharma, S., Katz, S., Clark, L. T., Jones, R. H.
(2006). Impact of Completeness of Percutaneous Coronary Intervention Revascularization on Long-Term Outcomes in the Stent Era. Circulation
113: 2406-2412
[Abstract][Full Text]
Silverman, M. E., Kounis, N. G., Kounis, G. N., Kouni, S. N., Taggart, D. P., Serruys, P. W., Ong, A. T.L.
(2006). Coronary-artery stents.. NEJM
354: 2076-2078
[Full Text]
Gillis, A. M.
(2006). Tincture of Time: When to Implant a Prophylactic Cardioverter-Defibrillator Following Coronary Revascularization?. J Am Coll Cardiol
47: 1818-1819
[Full Text]
Wan, S., Arifi, A. A., Chan, M. C.W., Yip, J. H.Y., Ng, C. S.H., Chow, L. T.C., Yim, A. P.C., Jeremy, J. Y.
(2006). Differential, time-dependent effects of perivenous application of fibrin glue on medial thickening in porcine saphenous vein grafts.. Eur. J. Cardiothorac. Surg.
29: 742-746
[Abstract][Full Text]
Rankin, J. S., Harrell, F. E. Jr
(2006). Measuring the therapeutic efficacy of coronary revascularization: Implications for future management. J. Thorac. Cardiovasc. Surg.
131: 944-948
[Full Text]
Vassiliades, T. A. Jr, Douglas, J. S., Morris, D. C., Block, P. C., Ghazzal, Z., Rab, S. T., Cates, C. U.
(2006). Integrated coronary revascularization with drug-eluting stents: Immediate and seven-month outcome. J. Thorac. Cardiovasc. Surg.
131: 956-962
[Abstract][Full Text]
Pugliese, F., Cademartiri, F., van Mieghem, C., Meijboom, W. B., Malagutti, P., Mollet, N. R. A., Martinoli, C., de Feyter, P. J., Krestin, G. P.
(2006). Multidetector CT for visualization of coronary stents.. RadioGraphics
26: 887-904
[Abstract][Full Text]
Ting, H. H., Raveendran, G., Lennon, R. J., Long, K. H., Singh, M., Wood, D. L., Gersh, B. J., Rihal, C. S., Holmes, D. R. Jr
(2006). A Total of 1,007 Percutaneous Coronary Interventions Without Onsite Cardiac Surgery: Acute and Long-Term Outcomes. J Am Coll Cardiol
47: 1713-1721
[Abstract][Full Text]
Dixon, S. R., Grines, C. L., O'Neill, W. W.
(2006). The Year in Interventional Cardiology. J Am Coll Cardiol
47: 1689-1706
[Full Text]
Pache, G., Saueressig, U., Frydrychowicz, A., Foell, D., Ghanem, N., Kotter, E., Geibel-Zehender, A., Bode, C., Langer, M., Bley, T.
(2006). Initial experience with 64-slice cardiac CT: non-invasive visualization of coronary artery bypass grafts. Eur Heart J
27: 976-980
[Abstract][Full Text]
Hordijk-Trion, M., Lenzen, M., Wijns, W., de Jaegere, P., Simoons, M. L., Scholte op Reimer, W. J.M., Bertrand, M. E., Mercado, N., Boersma, E., on behalf of the EHS-CR Investigators,
(2006). Patients enrolled in coronary intervention trials are not representative of patients in clinical practice: results from the Euro Heart Survey on Coronary Revascularization. Eur Heart J
27: 671-678
[Abstract][Full Text]
Williams, M. E.
(2006). Coronary Revascularization in Diabetic Chronic Kidney Disease/End-Stage Renal Disease: A Nephrologist's Perspective. CJASN
1: 209-220
[Full Text]
Klein, L. W.
(2006). Are Drug-Eluting Stents the Preferred Treatment for Multivessel Coronary Artery Disease?. J Am Coll Cardiol
47: 22-26
[Abstract][Full Text]
Flaherty, J. D., Davidson, C. J., Crouse, J. R. III, Rubin, S. A., Mody, F. V., Hannan, E. L., Walford, G., Jones, R. H.
(2005). Coronary-Artery Bypass Grafting versus Stent Implantation. NEJM
353: 735-737
[Full Text]
Califf, R. M.
(2005). Stenting or Surgery: An Opportunity to Do it Right. J Am Coll Cardiol
46: 589-591
[Full Text]
Malik, I.
(2005). JournalScan. Heart
91: 1118-1120
[Full Text]
(2005). CABG Better Than Stenting for Multivessel CAD?. Journal Watch Cardiology
2005: 1-1
[Full Text]
(2005). CABG vs. Stenting for Multivessel Coronary Disease. JWatch General
2005: 4-4
[Full Text]
Gersh, B. J., Frye, R. L.
(2005). Methods of Coronary Revascularization -- Things May Not Be as They Seem. NEJM
352: 2235-2237
[Full Text]
Previous
