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The Evolution of β-Blockers in Coronary Artery Disease and Heart Failure (Part 1/5) Transcatheter versus Surgical Aortic Valve Replacement in Patients with Prior Cardiac Surgery in the Randomized PARTNER 2A Trial A Combined Optical Coherence Tomography and Intravascular Ultrasound Study on Plaque Rupture, Plaque Erosion, and Calcified Nodule in Patients With ST-Segment Elevation Myocardial Infarction: Incidence, Morphologic Characteristics, and Outcomes After Percutaneous Coronary Intervention Predictors of high residual gradient after transcatheter aortic valve replacement in bicuspid aortic valve stenosis Long-term effects of intensive glucose lowering on cardiovascular outcomes Noninvasive Nuclear SPECT Myocardial Blood Flow Quantitation to Guide Management for Coronary Artery Disease Novel predictors of late lumen enlargement in distal reference segments after successful recanalization of coronary chronic total occlusion Rationale and design of a large-scale, app-based study to identify cardiac arrhythmias using a smartwatch: The Apple Heart Study Long-term outcome of prosthesis-patient mismatch after transcatheter aortic valve replacement 2019 Guidelines on Diabetes, Pre-Diabetes and Cardiovascular Diseases developed in collaboration with the EASD ESC Clinical Practice Guidelines
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Review ArticleVolume 74, Issue 25, December 2019

JOURNAL：J Am Coll Cardiol. Article Link

Limitations of Repeat Revascularization as an Outcome Measure

P Lamelas, J Belardi, R Whitlock et al. Keywords: CABG; coronary artery disease; PCI; revascularization

ABSTRACT

Repeat revascularization is a commonly used outcome measure in trials comparing percutaneous coronary intervention and coronary artery bypass graft surgery, and differences in this outcome often drive the relative risk for the primary endpoint. However, repeat revascularization as an outcome measure has important limitations that complicates its meaningful interpretation, including confounding by indication (driven by varying use of stress testing and thresholds for invasive angiography), differential likelihood of revascularization after graft versus stent failure, uncertainty of the prognostic impact of repeat revascularization, and patient preferences and appraisal of the import of repeat revascularization. Knowledge of these issues will result in better appreciation of the utility of repeat revascularization as a clinically meaningful outcome measure. The authors describe these issues and provide recommendations for the use and assessment of repeat revascularization as an endpoint when comparing different revascularization modalities.
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