Cardiovascular Events Related to the Coronary Artery Treated by Surgical or Percutaneous Revascularization in Patients With Stable Multivessel Coronary Artery Disease: A Long-Term Comparison With Medical Therapy - Target Trial
Trial Snapshot
- Phase
- Not Applicable
- Status
- Completed
- Sponsor
- Instituto do Coracao
- Enrollment
- 1,695
- Primary Endpoint
- Non-fatal myocardial infarction related to the treated coronary artery
Study Overview
Brief Summary
This retrospective cohort study evaluates cardiovascular events directly related to treated coronary arteries in patients with stable multivessel coronary artery disease. Outcomes in patients undergoing coronary artery bypass grafting or percutaneous coronary intervention will be compared with those receiving optimized medical therapy alone. This study aims to improve understanding of how different treatment strategies impact long-term vessel-related outcomes in patients with stable multivessel coronary artery disease.
Detailed Description
Previous studies evaluating coronary revascularization strategies have relied on broad composite endpoints, which may include events unrelated to the treated vessel. This study focuses on vessel-related outcomes, specifically non-fatal myocardial infarction and cardiac death attributable to the treated coronary artery. Patients were selected from the MASS (Medicine, Angioplasty, or Surgery Study) database at a single tertiary center. By analyzing vessel-specific events, this study aims to provide a more accurate assessment of the long-term impact of different treatment strategies in stable multivessel coronary artery disease.
Study Design
- Study Type
- Observational
- Observational Model
- Cohort
- Time Perspective
- Retrospective
Eligibility Criteria
- Ages
- 18 Years to — (Adult, Older Adult)
- Sex
- All
- Accepts Healthy Volunteers
- No
Inclusion Criteria
- •Patients with stable multivessel coronary artery disease, defined as ≥70% stenosis in at least two major epicardial coronary arteries, with documented myocardial ischemia and clinical indication for surgical, percutaneous, or medical treatment.
Exclusion Criteria
- •Patients with limited life expectancy, severe left ventricular dysfunction (ejection fraction <35%), recent acute coronary syndrome, recent revascularization procedures, significant valvular disease, chronic kidney disease (creatinine ≥2.0 mg/dL), active malignancy, or inability to complete long-term follow-up.
Arms & Interventions
Coronary Artery Bypass Grafting (CABG)
Patients with stable multivessel coronary artery disease treated with surgical coronary artery bypass grafting.
Intervention: Coronary Artery Bypass Grafting (Procedure)
Percutaneous Coronary Intervention (PCI)
Patients with stable multivessel coronary artery disease treated with percutaneous coronary intervention.
Intervention: Percutaneous Coronary Intervention (Procedure)
Medical Therapy
Patients with stable multivessel coronary artery disease treated exclusively with optimized medical therapy.
Intervention: Optimized Medical Therapy (Other)
Outcomes
Primary Outcomes
Non-fatal myocardial infarction related to the treated coronary artery
Time Frame: Up to 5 years of follow-up
Cardiac death attributable to the treated coronary artery
Time Frame: Up to 5 years of follow-up
Secondary Outcomes
No secondary outcomes reported
Investigators
Thiago Ovanessian Hueb
MD, PhD
Instituto do Coracao