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Contemporary prevalence of pulmonary arterial hypertension in adult congenital heart disease following the updated clinical classification Everolimus-eluting stent implantation for unprotected left main coronary artery stenosis. The PRECOMBAT-2 (Premier of Randomized Comparison of Bypass Surgery versus Angioplasty Using Sirolimus-Eluting Stent in Patients with Left Main Coronary Artery Disease) study Pulmonary Hypertension Caused by a Coconut Left Atrium Pulmonary Artery Denervation for Patients With Residual Pulmonary Hypertension After Pulmonary Endarterectomy Evaluation and Management of Aortic Stenosis in Chronic Kidney Disease: A Scientific Statement From the American Heart Association Low shear stress induces vascular eNOS uncoupling via autophagy-mediated eNOS phosphorylation Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease Incidence and Management of Restenosis After Treatment of Unprotected Left Main Disease With Second-Generation Drug-Eluting Stents (from Failure in Left Main Study With 2nd Generation Stents-Cardiogroup III Study) Radial versus femoral artery access in patients undergoing PCI for left main coronary artery disease: analysis from the EXCEL trial Definition and Management of Segmental Pulmonary Hypertension
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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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