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dc.contributor.authorJabbour, Samer
dc.contributor.authorYoung-Xu, Yinong
dc.contributor.authorGraboys, Thomas B.
dc.contributor.authorBlatt, Charles M.
dc.contributor.authorGoldberg, Robert J.
dc.contributor.authorBedell, Susanna E.
dc.contributor.authorBilchik, Brian Z.
dc.contributor.authorLown, Bernard
dc.contributor.authorRavid, Shmuel
dc.date2022-08-11T08:10:39.000
dc.date.accessioned2022-08-23T17:15:29Z
dc.date.available2022-08-23T17:15:29Z
dc.date.issued2004-02-05
dc.date.submitted2010-05-27
dc.identifier.citationAm J Cardiol. 2004 Feb 1;93(3):294-9. <a href="http://dx.doi.org/10.1016/j.amjcard.2003.10.007">Link to article on publisher's site</a>
dc.identifier.issn0002-9149 (Linking)
dc.identifier.doi10.1016/j.amjcard.2003.10.007
dc.identifier.pmid14759377
dc.identifier.urihttp://hdl.handle.net/20.500.14038/47177
dc.description.abstractThe objective of this study was to assess long-term clinical outcomes and their correlates in medically managed outpatients with stable angina pectoris, healed myocardial infarction (MI), or documented asymptomatic coronary artery disease (CAD). Management strategy emphasized maximally tolerated medical therapy and modification of coronary risk factors. Referral to invasive coronary interventions followed stricter criteria than standard published guidelines. Primary study outcomes were all-cause mortality or nonfatal myocardial infarction. Secondary study outcomes included cardiac death, unstable angina, or coronary revascularization. A total of 693 men and women with proved CAD (mean age 67 years at entry, 85% men, 41% with history of MI) were enrolled. The annual incidence of nonfatal MI, cardiac mortality, and total mortality was 2.2%, 0.8%, and 1.4%, respectively, during an average follow-up of 4.6 years. Coronary revascularization was performed in 24% of subjects; unstable or progressive anginal symptoms were the most common reasons for revascularization. In patients with documented stable CAD, a management strategy based on intensive medical therapy and modification of established coronary risk factors was associated with excellent long-term outcomes. Thus, coronary interventions can be safely delayed until clinical instability ensues, without increased risk of MI or death. This treatment approach represents a viable alternative to invasive strategies.
dc.language.isoen_US
dc.relation<a href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=pubmed&cmd=Retrieve&list_uids=14759377&dopt=Abstract">Link to Article in PubMed</a>
dc.relation.urlhttp://dx.doi.org/10.1016/j.amjcard.2003.10.007
dc.subjectAdult
dc.subjectAged
dc.subjectAged, 80 and over
dc.subject*Ambulatory Care
dc.subjectAngina Pectoris
dc.subjectCoronary Artery Disease
dc.subjectFemale
dc.subjectFollow-Up Studies
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectMyocardial Infarction
dc.subject*Patient-Centered Care
dc.subjectProspective Studies
dc.subjectTime Factors
dc.subjectTreatment Outcome
dc.subjectBioinformatics
dc.subjectBiostatistics
dc.subjectEpidemiology
dc.subjectHealth Services Research
dc.titleLong-term outcomes of optimized medical management of outpatients with stable coronary artery disease
dc.typeJournal Article
dc.source.journaltitleThe American journal of cardiology
dc.source.volume93
dc.source.issue3
dc.identifier.legacycoverpagehttps://escholarship.umassmed.edu/qhs_pp/324
dc.identifier.contextkey1333077
html.description.abstract<p>The objective of this study was to assess long-term clinical outcomes and their correlates in medically managed outpatients with stable angina pectoris, healed myocardial infarction (MI), or documented asymptomatic coronary artery disease (CAD). Management strategy emphasized maximally tolerated medical therapy and modification of coronary risk factors. Referral to invasive coronary interventions followed stricter criteria than standard published guidelines. Primary study outcomes were all-cause mortality or nonfatal myocardial infarction. Secondary study outcomes included cardiac death, unstable angina, or coronary revascularization. A total of 693 men and women with proved CAD (mean age 67 years at entry, 85% men, 41% with history of MI) were enrolled. The annual incidence of nonfatal MI, cardiac mortality, and total mortality was 2.2%, 0.8%, and 1.4%, respectively, during an average follow-up of 4.6 years. Coronary revascularization was performed in 24% of subjects; unstable or progressive anginal symptoms were the most common reasons for revascularization. In patients with documented stable CAD, a management strategy based on intensive medical therapy and modification of established coronary risk factors was associated with excellent long-term outcomes. Thus, coronary interventions can be safely delayed until clinical instability ensues, without increased risk of MI or death. This treatment approach represents a viable alternative to invasive strategies.</p>
dc.identifier.submissionpathqhs_pp/324
dc.contributor.departmentDepartment of Medicine, Division of Cardiovascular Medicine
dc.source.pages294-9


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