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http://hdl.handle.net/10773/24679
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DC Field | Value | Language |
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dc.contributor.author | Martins, José Luís | pt_PT |
dc.contributor.author | Afreixo, Vera | pt_PT |
dc.contributor.author | Santos, Luís | pt_PT |
dc.contributor.author | Costa, Marco | pt_PT |
dc.contributor.author | Santos, José | pt_PT |
dc.contributor.author | Gonçalves, Lino | pt_PT |
dc.date.accessioned | 2018-11-19T15:46:42Z | - |
dc.date.available | 2018-11-19T15:46:42Z | - |
dc.date.issued | 2018-10 | - |
dc.identifier.issn | 2048-8726 | pt_PT |
dc.identifier.uri | http://hdl.handle.net/10773/24679 | - |
dc.description.abstract | INTRODUCTION: Patients presenting with spontaneous coronary artery dissection (SCAD) may receive either conservative medical management or a revascularisation strategy. There is still a lack of consensus with respect to the best treatment approach for SCAD. OBJECTIVES: We sought to determine whether outcomes differ between the first-line treatment approaches (conservative versus revascularisation) in patients with SCAD. METHODS: We searched Medline, EMBASE and the Cochrane Library for studies published from January 1990 to November 2016 that compared first-line treatments for patients with SCAD. We conducted a pooled risk ratio meta-analysis for four main outcomes: mortality, myocardial infarction (MI), SCAD recurrence and target vessel revascularisation (TVR). RESULTS: We identified 11 non-randomised studies that included a total of 631 patients. A pooled meta-analysis showed no significant difference between conservative management and revascularisation approaches in mortality (risk difference [RD] = 0.01; 95% confidence interval [CI] = -0.01 to 0.04; I2 = 0%; p = 1), MI (RD = -0.01; 95% CI = -0.04 to 0.03; I2 = 0%; p = 0.5) or SCAD recurrence (RD = -0.01; 95% CI = -0.06 to 0.05; I2 = 0%; p = 0.74). Revascularisation as an initial first-line approach was associated with an estimated additional risk of TVR of 6.3% (RD = 0.06; 95% CI = 0.01-0.11; I2 = 0%; p = 0.96). CONCLUSION: The results demonstrate an increased risk of TVR when revascularisation was used as the initial first-line treatment approach. The treatment decision must be individualised and be based on both clinical and angiographic factors, but conservative therapy should prevail in most cases. | pt_PT |
dc.language.iso | eng | pt_PT |
dc.publisher | SAGE Publications | pt_PT |
dc.rights | restrictedAccess | pt_PT |
dc.rights.uri | https://creativecommons.org/licenses/by/4.0/ | pt_PT |
dc.subject | Spontaneous coronary artery dissection | pt_PT |
dc.subject | Medical treatment | pt_PT |
dc.subject | Revascularisation | pt_PT |
dc.subject | Mortality | pt_PT |
dc.subject | Myocardial infarction | pt_PT |
dc.subject | Spontaneous coronary artery dissection recurrence | pt_PT |
dc.subject | Target vessel revascularisation | pt_PT |
dc.title | Medical treatment or revascularisation as the best approach for spontaneous coronary artery dissection: A systematic review and meta-analysis | pt_PT |
dc.type | article | pt_PT |
dc.description.version | published | pt_PT |
dc.peerreviewed | yes | pt_PT |
degois.publication.firstPage | 614 | pt_PT |
degois.publication.issue | 7 | pt_PT |
degois.publication.lastPage | 623 | pt_PT |
degois.publication.title | European heart journal. Acute cardiovascular care | pt_PT |
degois.publication.volume | 7 | pt_PT |
dc.identifier.doi | 10.1177/2048872617706502 | pt_PT |
dc.identifier.essn | 2048-8734 | pt_PT |
Appears in Collections: | CIDMA - Artigos IBIMED - Artigos DMat - Artigos PSG - Artigos |
Files in This Item:
File | Description | Size | Format | |
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Martins2018c.pdf | 777.72 kB | Adobe PDF |
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