Factors affecting the therapeutic choice in patients with multivessel coronary artery disease

Stefano De Servi, Stefano Galli, Marco Onofri, Enrico Boschetti, Rossella Oberti, Luigi Niccoli, Anna Maria De Biase, Gianni Rovelli, Massimo Carini, Francesca Regalia, Paolo Valentini, Antonio Bartorelli

Research output: Contribution to journalArticle

4 Citations (Scopus)

Abstract

Objective - To assess how clinical and angiographic findings are related to the decision to carry out coronary angioplasty (PTCA) or coronary bypass grafting in patients with multivessel coronary artery disease. Design - Prospective survey carried out in 14 centres in the Lombardia region of Italy. Patients - 1468 consecutive patients under going coronary arteriography for known or suspected ischaemic heart disease between May and October 1994, who were found to have multivessel coronary artery disease. Main outcome measures - Multivariate analysis was undertaken using stepwise logistic regression to identify the clinical and angiographic variables correlated with revascularisation (υ medical treatment) in all of patients, and with surgery (υ angioplasty) in the subset of revascularised patients. Results -In all patients the clinical decision after coronary arteriography was made by physicians of each participating centre on the basis of their experience and clinical judgment: 53% of patients had bypass surgery, 28% had PTCA, and 19% continued medical treatment. The choice of a revascularisation procedure was directly related to a clinical diagnosis of unstable angina (P

Original languageEnglish
Pages (from-to)443-448
Number of pages6
JournalHeart
Volume77
Issue number5
Publication statusPublished - 1997

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Coronary Artery Disease
Angioplasty
Therapeutics
Angiography
Unstable Angina
Italy
Myocardial Ischemia
Multivariate Analysis
Logistic Models
Outcome Assessment (Health Care)
Physicians

Keywords

  • Clinical decision making
  • Coronary angioplasty
  • Coronary artery disease
  • Coronary bypass surgery

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Factors affecting the therapeutic choice in patients with multivessel coronary artery disease. / De Servi, Stefano; Galli, Stefano; Onofri, Marco; Boschetti, Enrico; Oberti, Rossella; Niccoli, Luigi; De Biase, Anna Maria; Rovelli, Gianni; Carini, Massimo; Regalia, Francesca; Valentini, Paolo; Bartorelli, Antonio.

In: Heart, Vol. 77, No. 5, 1997, p. 443-448.

Research output: Contribution to journalArticle

De Servi, S, Galli, S, Onofri, M, Boschetti, E, Oberti, R, Niccoli, L, De Biase, AM, Rovelli, G, Carini, M, Regalia, F, Valentini, P & Bartorelli, A 1997, 'Factors affecting the therapeutic choice in patients with multivessel coronary artery disease', Heart, vol. 77, no. 5, pp. 443-448.
De Servi, Stefano ; Galli, Stefano ; Onofri, Marco ; Boschetti, Enrico ; Oberti, Rossella ; Niccoli, Luigi ; De Biase, Anna Maria ; Rovelli, Gianni ; Carini, Massimo ; Regalia, Francesca ; Valentini, Paolo ; Bartorelli, Antonio. / Factors affecting the therapeutic choice in patients with multivessel coronary artery disease. In: Heart. 1997 ; Vol. 77, No. 5. pp. 443-448.
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AU - Onofri, Marco

AU - Boschetti, Enrico

AU - Oberti, Rossella

AU - Niccoli, Luigi

AU - De Biase, Anna Maria

AU - Rovelli, Gianni

AU - Carini, Massimo

AU - Regalia, Francesca

AU - Valentini, Paolo

AU - Bartorelli, Antonio

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N2 - Objective - To assess how clinical and angiographic findings are related to the decision to carry out coronary angioplasty (PTCA) or coronary bypass grafting in patients with multivessel coronary artery disease. Design - Prospective survey carried out in 14 centres in the Lombardia region of Italy. Patients - 1468 consecutive patients under going coronary arteriography for known or suspected ischaemic heart disease between May and October 1994, who were found to have multivessel coronary artery disease. Main outcome measures - Multivariate analysis was undertaken using stepwise logistic regression to identify the clinical and angiographic variables correlated with revascularisation (υ medical treatment) in all of patients, and with surgery (υ angioplasty) in the subset of revascularised patients. Results -In all patients the clinical decision after coronary arteriography was made by physicians of each participating centre on the basis of their experience and clinical judgment: 53% of patients had bypass surgery, 28% had PTCA, and 19% continued medical treatment. The choice of a revascularisation procedure was directly related to a clinical diagnosis of unstable angina (P

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