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Prophylactic coronary artery revascularisation before elective vascular surgery did not improve long term survival

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 Q In patients with stable coronary artery disease (CAD) who are scheduled for elective major vascular surgery, does prophylactic coronary artery revascularisation reduce long term, all cause mortality?

Clinical impact ratings GP/FP/Primary care ★★★★★★☆ IM/Ambulatory care ★★★★★★☆ Internal medicine ★★★★★★☆ Cardiology ★★★★★★☆


Embedded ImageDesign:

randomised controlled trial (RCT) (Coronary Artery Revascularization Prophylaxis [CARP] trial).

Embedded ImageAllocation:


Embedded ImageBlinding:

blinded ({investigators} and the endpoints committee that validated all outcomes).*

Embedded ImageFollow up period:

median 2.7 years.

Embedded ImageSetting:

18 Veterans Affairs medical centres in the US.

Embedded ImagePatients:

510 patients (mean age 66 y, 98% men) with stable CAD (⩾70% stenosis in ⩾1 major coronary artery suitable for revascularisation) who were scheduled for elective major vascular operation for an expanding abdominal aortic aneurysm or severe symptoms of …

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  • * See glossary.

  • Information provided by author.

  • For correspondence: Dr E O McFalls, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA.

  • Source of funding: Cooperative Studies Program of the Department of Veterans Affairs Office of Research and Development.