ArticleJACC. Cardiovascular interventions2016
Computing Methods for Composite Clinical Endpoints in Unprotected Left Main Coronary Artery Revascularization: A Post Hoc Analysis of the DELTA Registry.
Article in JACC. Cardiovascular interventions, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 12 papers, 1 of them a synthesis that pooled it.
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Who cites it
12 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Percutaneous Coronary Intervention vs Coronary Artery Bypass Grafting in Patients With Left Main Coronary Artery Stenosis: A Systematic Review and Meta-analysis.JAMA cardiology · 2017Pooled it
- Prioritised endpoints for device-based hypertension trials: the win ratio methodology.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2021Trial
- Prognostic value of pan immune-inflammation value in patients undergoing unprotected left main coronary artery stenting.Biomarkers in medicine · 2024Observational
- Making Sense of Composite Endpoints in Clinical Research.Journal of clinical medicine · 2023Review
- The empirical estimate of the survival and variance using a weighted composite endpoint.BMC medical research methodology · 2023Article
- Risk Burden of Coronary Perforation in Chronic Total Occlusion Recanalization: Latin American CTO Registry Analysis.Journal of the American Heart Association · 2022Article
- Statistical methods for composite endpoints.EuroIntervention : journal of EuroPCR in collaboration with the Working Group on Interventional Cardiology of the European Society of Cardiology · 2021Article
- Choosing primary endpoints for clinical trials of health care interventions.Contemporary clinical trials communications · 2019Review
- The Current State of Left Main Percutaneous Coronary Intervention.Current atherosclerosis reports · 2018Review
- Triaging patients with left main disease after the EXCEL and NOBLE trials: the everlasting saga of coronary artery bypass grafting and percutaneous coronary intervention.Journal of thoracic disease · 2017Article
- Statistical Approaches to Composite Endpoints.JACC. Cardiovascular interventions · 2016Article
- Long-term outcomes following left main bifurcation stenting in Indian population-Analysis based on SYNTAX I and II scores.Indian heart journalObservational
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33 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectivesThe study sought to investigate the impact of different computing methods for composite endpoints other than time-to-event (TTE) statistics in a large, multicenter registry of unprotected left main coronary artery (ULMCA) disease.
backgroundTTE statistics for composite outcome measures used in ULMCA studies consider only the first event, and all the contributory outcomes are handled as if of equal importance.
methodsThe TTE, Andersen-Gill, win ratio (WR), competing risk, and weighted composite endpoint (WCE) computing methods were applied to ULMCA patients revascularized by percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG) at 14 international centers.
resultsAt a median follow-up of 1,295 days (interquartile range: 928 to 1,713 days), all analyses showed no difference in combinations of death, myocardial infarction, and cerebrovascular accident between PCI and CABG. When target vessel revascularization was incorporated in the composite endpoint, the TTE (p = 0.03), Andersen-Gill (p = 0.04), WR (p = 0.025), and competing risk (p < 0.001) computing methods showed CABG to be significantly superior to PCI in the analysis of 1,204 propensity-matched patients, whereas incorporating the clinical relevance of the component endpoints using WCE resulted in marked attenuation of the treatment effect of CABG, with loss of significance for the difference between revascularization strategies (p = 0.10).
conclusionsIn a large study of ULMCA revascularization, incorporating the clinical relevance of the individual outcomes resulted in sensibly different findings as compared with the conventional TTE approach. In particular, using the WCE computing method, PCI and CABG were no longer significantly different with respect to the composite of death, myocardial infarction, cerebrovascular accident, or target vessel revascularization at a median of 3 years.
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