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Myocardial Revascularization Trials Beyond the Printed Word

Ruel, M; Falk, V; Farkouh, ME; Freemantle, N; Gaudino, MF; Glineur, D; Cameron, DE; (2018) Myocardial Revascularization Trials Beyond the Printed Word. Circulation , 138 (25) pp. 2943-2951. 10.1161/CIRCULATIONAHA.118.035970. Green open access

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Abstract

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.

Type: Article
Title: Myocardial Revascularization Trials Beyond the Printed Word
Open access status: An open access version is available from UCL Discovery
DOI: 10.1161/CIRCULATIONAHA.118.035970
Publisher version: https://doi.org/10.1161/CIRCULATIONAHA.118.035970
Language: English
Additional information: This version is the author accepted manuscript. For information on re-use, please refer to the publisher’s terms and conditions.
Keywords: clinical trials as topic, coronary artery disease, coronary stenosis, percutaneous coronary intervention, surgical procedures, operative, treatment outcomes
UCL classification: UCL
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology
UCL > Provost and Vice Provost Offices > School of Life and Medical Sciences > Faculty of Population Health Sciences > Inst of Clinical Trials and Methodology > Comprehensive CTU at UCL
URI: https://discovery.ucl.ac.uk/id/eprint/10066455
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