PMID- 26716589
OWN - NLM
STAT- MEDLINE
DCOM- 20170111
LR  - 20170112
IS  - 1557-2501 (Electronic)
IS  - 1042-3931 (Linking)
VI  - 28
IP  - 1
DP  - 2016 Jan
TI  - Revascularization Strategies for Calcified Lesions in Patients Presenting With 
      Acute Coronary Syndromes (From the Acute Catheterization and Urgent Intervention 
      Triage StrategY [ACUITY] Trial).
PG  - 10-6
AB  - BACKGROUND: Revascularization of calcified coronary lesions has been shown to be 
      associated with suboptimal outcomes. The optimal revascularization strategy for 
      calcified lesions in patients presenting with non-ST segment elevation acute 
      coronary syndromes (NSTEACS) has yet to be defined. METHODS: Outcomes in patients 
      presenting with NSTEACS and moderately or severely calcified target lesions in 
      native coronary vessels, as assessed by an independent angiographic core lab, 
      were examined according to revascularization strategy (percutaneous coronary 
      intervention [PCI] vs coronary artery bypass graft [CABG] surgery) from the 
      large-scale, prospective ACUITY trial. Propensity-adjusted multivariable analysis 
      was used to identify the independent predictors of events at 30 days. RESULTS: Of 
      1315 NSTEACS patients with moderately and severely calcified lesions in whom 
      revascularization was performed, a total of 334 (25%) and 981 (75%) underwent 
      CABG and PCI, respectively. CABG patients had more severe baseline comorbidities 
      and coronary artery disease. By propensity-adjusted multivariable analysis, the 
      CABG group had higher 30-day rates of reinfarction, composite death or 
      reinfarction, major bleeding, and thrombocytopenia. CONCLUSIONS: In this 
      large-scale study of patients presenting for NSTEACS, 30-day adverse events were 
      more frequent after revascularization of calcified coronary lesions with CABG 
      rather than PCI. Further studies are warranted to evaluate means of improving 
      early safety outcomes in this high-risk patient group with complex coronary 
      disease.
FAU - Tarigopula, Madhusudhan
AU  - Tarigopula M
FAU - Genereux, Philippe
AU  - Genereux P
FAU - Madhavan, Mahesh V
AU  - Madhavan MV
FAU - Parvataneni, Rupa
AU  - Parvataneni R
FAU - Weisz, Giora
AU  - Weisz G
FAU - Mehran, Roxana
AU  - Mehran R
FAU - Stone, Gregg W
AU  - Stone GW
AD  - Columbia University Medical Center, Cardiovascular Research Foundation, 111 E. 
      59th St., 11th Floor, New York, NY 10022 USA. gs2184@columbia.edu.
LA  - eng
PT  - Journal Article
PT  - Multicenter Study
PT  - Randomized Controlled Trial
PL  - United States
TA  - J Invasive Cardiol
JT  - The Journal of invasive cardiology
JID - 8917477
SB  - IM
MH  - *Acute Coronary Syndrome/diagnosis/etiology/physiopathology/surgery
MH  - Aged
MH  - Cardiac Catheterization/adverse effects/methods
MH  - Coronary Angiography/methods
MH  - *Coronary Artery Bypass/adverse effects/methods
MH  - *Coronary Vessels/diagnostic imaging/pathology/surgery
MH  - Female
MH  - Humans
MH  - Male
MH  - Middle Aged
MH  - *Myocardial Infarction/diagnosis/etiology
MH  - *Percutaneous Coronary Intervention/adverse effects/methods
MH  - *Postoperative Hemorrhage/diagnosis/etiology
MH  - Risk Assessment/methods
MH  - Risk Factors
MH  - Treatment Outcome
MH  - *Vascular Calcification/diagnostic imaging/physiopathology/surgery
EDAT- 2015/12/31 06:00
MHDA- 2017/01/12 06:00
CRDT- 2015/12/31 06:00
PHST- 2015/12/31 06:00 [entrez]
PHST- 2015/12/31 06:00 [pubmed]
PHST- 2017/01/12 06:00 [medline]
PST - ppublish
SO  - J Invasive Cardiol. 2016 Jan;28(1):10-6.