title: Factors influencing clinical outcomes after revascularization in the asymptomatic cardiac ischemia pilot (ACIP). ACIP Study Group.
abstract: OBJECTIVE
  The Asymptomatic Cardiac Ischemia Pilot is the first randomized trial where revascularization involved choice of either coronary bypass or angioplasty used in an early or a delayed symptom-driven approach. One-year outcomes were favorable (reduced recurrent ischemia and adverse outcomes) for an early revascularization strategy (within 4 weeks), compared with an early medical strategy when revascularization was delayed until symptom-driven. This ancillary study examined variables influencing outcomes after these 2 revascularization approaches (early vs. delayed until symptom-driven).
  
  
  METHODS
  Participants were clinically stable coronary disease patients with stress-induced and daily life ischemia who underwent revascularization. Characteristics associated with clinical outcomes occurring within the year following revascularization were examined using Cox regression analysis.
  
  
  RESULTS
  A total of 262 patients received revascularization; 170 in the early approach and 92 in the delayed symptom-driven approach. Thirty-three patients had adverse outcomes (death, nonfatal myocardial infarction, or repeat revascularization) during 1-year follow-up. The most important independent predictor of improved outcome during the follow-up year was attempted revascularization of > or = 66% of vessels with significant stenosis for the early (risk ratio [RR] 0.25, 95% confidence interval [CI] 0.09-0.67) and the delayed (RR 0.21, CI 0.08-0.58) approaches. Factors such as age, stress test results, and coronary angiographic findings did not predict clinical outcome.
  
  
  CONCLUSIONS
  Our findings are important in the planning of a large trial with longer follow-up.
authors.affiliation: University of Florida, College of Medicine, Division of Cardiovascular Medicine, Gainesville 32610-0277, USA.
authors.forename: C J
authors.initials: CJ
authors.lastname: Pepine
authors.forename: M G
authors.initials: MG
authors.lastname: Bourassa
authors.forename: B R
authors.initials: BR
authors.lastname: Chaitman
authors.forename: R F
authors.initials: RF
authors.lastname: Davies
authors.forename: R A
authors.initials: RA
authors.lastname: Kerensky
authors.forename: B
authors.initials: B
authors.lastname: Sharaf
authors.forename: G L
authors.initials: GL
authors.lastname: Knatterud
authors.forename: S A
authors.initials: SA
authors.lastname: Forman
authors.forename: C M
authors.initials: CM
authors.lastname: Pratt
authors.forename: E D
authors.initials: ED
authors.lastname: Staples
authors.forename: G
authors.initials: G
authors.lastname: Sopko
authors.forename: C R
authors.initials: CR
authors.lastname: Conti
mesh_terms: D000328:Adult; D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001026:Coronary Artery Bypass; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D017202:Myocardial Ischemia / Q000175:diagnosis / Q000401:mortality / Q000628:therapy*; D010865:Pilot Projects; D012044:Regression Analysis; D019233:Retreatment; D015996:Survival Rate; D013997:Time Factors; D016896:Treatment Outcome