TY - JOUR
T1 - Myocardial Revascularization Trials Beyond the Printed Word
AU - Ruel, Marc
AU - Falk, Volkmar
AU - Farkouh, Michael E.
AU - Freemantle, Nick
AU - Gaudino, Mario Fulvio Luigi
AU - Glineur, David
AU - Cameron, Duke E.
AU - Taggart, David P.
PY - 2018
Y1 - 2018
N2 - This article reviews the context and evidence of recent myocardial revascularization trials that compared percutaneous coronary intervention with coronary artery bypass grafting for the treatment of left main and multivessel coronary artery disease. We develop the rationale that some of the knowledge synthesis resulting from these trials, particularly with regard to the claimed noninferiority of percutaneous coronary intervention beyond nondiabetic patients with low anatomic complexity, may have been affected by trial design, patient selection based on suitability for percutaneous coronary intervention, and end point optimization favoring percutaneous coronary intervention over coronary artery bypass grafting. We provide recommendations that include holding a circumspect interpretation of the currently available evidence, as well as suggestions for the collaborative design and conduct of future clinical trials in this and other fields.
AB - This article reviews the context and evidence of recent myocardial revascularization trials that compared percutaneous coronary intervention with coronary artery bypass grafting for the treatment of left main and multivessel coronary artery disease. We develop the rationale that some of the knowledge synthesis resulting from these trials, particularly with regard to the claimed noninferiority of percutaneous coronary intervention beyond nondiabetic patients with low anatomic complexity, may have been affected by trial design, patient selection based on suitability for percutaneous coronary intervention, and end point optimization favoring percutaneous coronary intervention over coronary artery bypass grafting. We provide recommendations that include holding a circumspect interpretation of the currently available evidence, as well as suggestions for the collaborative design and conduct of future clinical trials in this and other fields.
KW - clinical trials as topic
KW - coronary artery disease
KW - coronary stenosis
KW - percutaneous coronary intervention
KW - surgical procedures, operative
KW - treatment outcomes
KW - clinical trials as topic
KW - coronary artery disease
KW - coronary stenosis
KW - percutaneous coronary intervention
KW - surgical procedures, operative
KW - treatment outcomes
UR - http://hdl.handle.net/10807/172671
U2 - 10.1161/CIRCULATIONAHA.118.035970
DO - 10.1161/CIRCULATIONAHA.118.035970
M3 - Article
SN - 0009-7322
VL - 138
SP - 2943
EP - 2951
JO - Circulation
JF - Circulation
ER -