Characteristics, Treatment and Outcome of Patients with Non-ST-Elevation Acute Coronary Syndromes and Multivessel Coronary Artery Disease: Observations from PURSUIT (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrelin Therapy)

Boersma, Eric; Breeman, Arno; Mercado, Nestor; Lenzen, Mattie; van den Brand, Marcel M.J.; Harrington, Robert A.; Califf, Robert M.; Topol, Eric J.; Simoons, Maarten L.
November 2002
Cardiology;2002, Vol. 98 Issue 4, p195
Academic Journal
Background: The 6-month clinical outcome of patients with multivessel disease enrolled in PURSUIT (Platelet Glycoprotein IIb/IIIa in Unstable Angina: Receptor Suppression Using Integrilin Therapy) is described. Patients with complete angiography data were included; multivessel disease was stratified according to the treatment strategy applied early during hospitalization, i.e. medical treatment, percutaneous coronary intervention (PCI) (balloon), PCI (stent), or coronary artery bypass grafting (CABG). Methods: Patients were divided into three groups according to the treatment strategy applied during the first 30 days of enrolment. Patients who did not undergo a percutaneous or surgical coronary intervention were classified as medically treated. Patients who underwent a PCI (prior to a possible CABG) were separated from those who underwent a CABG (prior to a possible PCI). The PCI group was further subdivided: patients receiving ≥1 coronary stents were separated from those in whom no stents were used. Results: The mortality rate at 30 days was 6.7, 3.9, 2.4 and 4.8% for the medical treatment, PCI (balloon), PCI (stent) and CABG groups, respectively (p value = 0.002). Differences as observed at 30 days were still present at 6-month follow-up with 11.1, 5.8, 5.5 and 6.5% mortality event rates for the aforementioned groups (p value = 0.002). The 30-day myocardial infarction (MI) rate according to the opinion of the Clinical Events Committee was lower among medically than non-medically treated patients, with the highest event rate observed in the CABG group (27.7%). Approximately half of the MIs in the PCI and CABG subgroups occurred within 48 h after the procedure. Conclusions: The observed differences in clinical outcomes are explained by an imbalance in baseline characteristics and comorbid conditions between the analyzed groups of patients.Copyright © 2002 S. Karger AG, Basel


Related Articles

  • Debate over patient-centered care: Percutaneous coronary intervention or coronary artery bypass grafting? KAWASUJI, MICHIO // Surgery Today;Apr2011, Vol. 41 Issue 4, p459 

    Coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI) have developed as effective therapies to treat coronary artery disease. Initial CABG is associated with lower mortality than initial medical management, especially among high- and intermediate-risk patients with...

  • Catheter-based Treatment of In-stent Restenosis: A Review. Erdöt, Cevdet; Çelik, Şükrü; Baykan, Merih // International Journal of Angiology (Springer Science & Business ;Fall2003, Vol. 12 Issue 4, p213 

    Stenting is a safe and efficient method for treatment of ischaemic heart disease. Nevertheless, it gives rise to some additional problems, especially in-stent restenosis. Several techniques including balloon angioplasty, restenting, rotaablation, excimer laser angioplasty, directional coronary...

  • Revascularization in the 21st century. Pinkowish, Mary Desmond // Patient Care for the Nurse Practitioner;Jan2001, Vol. 4 Issue 1, p36 

    Presents information on advances and developments in coronary revascularization. Issues surrounding the use of coronary artery bypass graft and percutaneous transluminal angioplasty; Developments in stent-based therapies; Advances in surgical treatments.

  • Stents beat angioplasty for reducing cardiac events, but not for restenosis.  // Modern Medicine;Jan98, Vol. 66 Issue 1, p22 

    Discusses the abstract of the article `Stent placement compared with balloon angioplasty for obstructed coronary bypass grafts,' by M.P. Savage, J.S. Douglas Jr. et al, which appeared in the September 11, 1997 issue of `National English Journal of Medicine.'

  • Is Postdilatation with a Noncompliant Balloon Necessary after Coronary Stent Deployment during Primary Angioplasty? TASAL, ABDURRAHMAN; BACAKSIZ, AHMET; VATANKULU, MEHMET AKIF; TURFAN, MURAT; ERDOGAN, ERCAN; SONMEZ, OSMAN; KUL, SEREF; ERTAS, GOKHAN; SEVGILI, EMRAH; GOKTEKIN, OMER // Journal of Interventional Cardiology;Aug2013, Vol. 26 Issue 4, p325 

    Background Postdilatation (PD) with noncompliant balloon during elective percutaneous coronary intervention (PCI) is performed usually in clinical practice in order to optimize stent expansion. However, current knowledge about its use in patients undergoing primary PCI is controversial. This...

  • Coronary Artery Bypass Graft Versus Percutaneous Coronary Intervention: Status of the Trials. King, III, Spencer B. // Journal of Interventional Cardiology;Oct2006 Supplement, Vol. 19, pS3 

    Trials of balloon angioplasty versus bypass surgery for coronary artery disease showed essential equivalent survival except in diabetic patients. Reintervention following percutaneous coronary intervention was much more frequent and was reduced in subsequent stent trials. Drug-eluting stents now...

  • Graft vs stent for severe coronary artery disease.  // British Journal of Hospital Medicine (17508460);Mar2009, Vol. 70 Issue 3, p130 

    The article focuses on the synergy between percutaneous coronary intervention with a paclitaxel-eluting stent (PCI) with Taxus and Cardiac surgery (SYNTAX ) trial which found that coronary artery bypass grafting (CABG) can treat patients with severe coronary artery disease. It intends to...

  • Percutaneous transluminal coronary angioplasty in octogenarians. Jeroudi, Mohamed O.; Kleiman, Neal S.; Minor, Steven T.; Hess, Kenneth R.; Lewis, John M.; Winters, William L.; Raizner, Albert E.; Jeroudi, M O; Kleiman, N S; Minor, S T; Hess, K R; Lewis, J M; Winters, W L Jr; Raizner, A E // Annals of Internal Medicine;9/15/90, Vol. 113 Issue 6, p423 

    Objective: To assess the safety and short- and long-term outcomes of percutaneous transluminal coronary angioplasty in octogenarians.Design: Retrospective chart review of clinical series.Setting: Referral-based university medical center.Patients:...

  • Drug-Eluting Stents in Multivessel Coronary Artery Disease: Cost Effectiveness and Clinical Outcomes. Panchal, Kanaiya; Patel, Snehal; Bhatt, Parloop // Advances in Pharmacological Sciences;2012, Vol. 2012, p1 

    Multivessel coronary artery disease is more often treated either with coronary artery bypass surgery (CABG) or percutaneous coronary intervention (PCI) with stenting. The advent of drug-eluting stent (DES) has changed the revascularization strategy, and caused an increase in the use of DES in...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics