Publications by authors named "A P Kappetein"
Background: The incidence and prognostic impact of major bleeding (MB) after percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) for left main coronary artery disease (LMCAD) are unknown.
Objectives: The goal of this study was to investigate the rates and outcomes of MB after LMCAD revascularization.
Methods: In the EXCEL (Evaluation of XIENCE versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization) trial, 1,905 patients with unprotected LMCAD were randomized to undergo PCI (n = 948) or CABG (n = 957) and followed up for 5 years.
Objectives: Average treatment effects from randomized trials do not reflect the heterogeneity of an individual's response to treatment. This study evaluates the appropriate proportions of patients for coronary artery bypass grafting, or percutaneous intervention based on the predicted/observed ratio of 10-year all-cause mortality in the SYNTAX population.
Methods: The study included 1800 randomized patients and 1275 patients in the nested percutaneous (n = 198) or surgical (n = 1077) registries.
Background: Recently, machine learning algorithms have identified preprocedural γ-glutamyl transferase (GGT) as a significant predictor of long-term mortality after coronary revascularization in the SYNTAX (Synergy Between PCI [Percutaneous Coronary Intervention] With Taxus and Cardiac Surgery) trial. The aim of the present study is to investigate the impact of preprocedural GGT on 10-year all-cause mortality in patients with complex coronary artery disease after revascularization.
Methods And Results: The SYNTAX trial was a randomized trial comparing PCI with coronary artery bypass grafting in 1800 patients with complex coronary artery disease.
Article Synopsis
- - The study examined how complete revascularization after percutaneous coronary intervention (PCI) impacts patients with left main coronary artery disease, using data from the EXCEL trial involving 903 patients over a 5-year follow-up.
- - Findings showed that the risk of death or myocardial infarction (MI) did not significantly differ based on traditional measures of complete revascularization but was notably higher with a higher residual Jeopardy Score (rJS), particularly for patients with untreated severe stenoses in the left circumflex artery (LCX).
- - Specifically, patients with an rJS of 4 or more had worse outcomes, with increased mortality and spontaneous MI, highlighting the importance of addressing untreated high-grade lesions post-PCI for