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

https://doi.org/10.1136/ebm.10.4.114

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    McFalls EO, Ward HB, Moritz TE, et al. Coronary-artery revascularization before elective major vascular surgery. N Engl J Med 2004;351:2795–804.
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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 ★★★★★★☆

    METHODS

    Embedded ImageDesign:

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

    Embedded ImageAllocation:

    {concealed*}†.

    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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    Footnotes

    • ↵* See glossary.

    • ↵† Information provided by author.

    • For correspondence: Dr E O McFalls, Minneapolis Veterans Affairs Medical Center, Minneapolis, MN, USA. mcfal001tc.umn.edu

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