Rates of major adverse cardiac events noninferior with treatment at hospital without on-site surgery
MONDAY, March 11 (HealthDay News) -- For patients undergoing nonemergency percutaneous coronary intervention (PCI), clinical outcomes at 30 days and one year are similar with and without on-site cardiac surgery services, according to a study published online March 11 in the New England Journal of Medicine to coincide with presentation at the annual meeting of the American College of Cardiology, held from March 9 to 11 in San Francisco.
Alice K. Jacobs, M.D., from Boston Medical Center, and colleagues compared outcomes during and after PCI for patients treated at hospitals with and without on-site cardiac surgery services. Participants with indications for nonemergency PCI who presented to hospitals were randomly allocated to undergo PCI at a hospital without on-site cardiac surgery (2,774 patients) or at a hospital with on-site cardiac surgery (917 patients).
The researchers found that at 30 days the rates of major adverse cardiac events were 9.5 and 9.4 percent in hospitals without and with on-site cardiac surgery (relative risk, 1.00; P < 0.001 for noninferiority). At one year, the corresponding rates were 17.3 and 17.8 percent, respectively (relative risk, 0.98; P < 0.001 for noninferiority). There was no significant difference between the groups at either time point with respect to the rates of death, myocardial infarction, repeat revascularization, and stroke.
"Nonemergency PCI procedures performed at hospitals in Massachusetts without on-site surgical services were noninferior to procedures performed at hospitals with on-site surgical services with respect to the 30-day and one-year rates of clinical events," the authors write.
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