Tags

Type your tag names separated by a space and hit enter

The medicine, angioplasty, or surgery study (MASS-II): a randomized, controlled clinical trial of three therapeutic strategies for multivessel coronary artery disease: one-year results.
J Am Coll Cardiol. 2004 May 19; 43(10):1743-51.JACC

Abstract

OBJECTIVES

We sought to evaluate the relative efficacies of three possible therapeutic strategies for patients with multivessel coronary artery disease (CAD), stable angina, and preserved ventricular function.

BACKGROUND

Despite routine use of coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI), there is no conclusive evidence that either one is superior to medical therapy (MT) alone for the treatment of multivessel CAD.

METHODS

The primary end point was defined as cardiac mortality, Q-wave myocardial infarction (MI), or refractory angina requiring revascularization. All data were analyzed according to the intention-to-treat principle.

RESULTS

A total of 611 patients were randomly assigned to either a CABG (n = 203), PCI (n = 205), or MT (n = 203) group. The one-year survival rates were 96.0% for CABG, 95.6% for PCI, and 98.5% for MT. The rates for one-year survival free of Q-wave MI were 98% for CABG, 92% for PCI, and 97% for MT. After one-year follow-up, 8.3% of MT patients and 13.3% of PCI patients underwent to additional interventions, compared with only 0.5% of CABG patients. At one-year follow-up, 88% of the patients in the CABG group, 79% in the PCI group, and 46% in the MT group were free of angina (p < 0.0001).

CONCLUSIONS

Medical therapy for multivessel CAD was associated with a lower incidence of short-term events and a reduced need for additional revascularization, compared with PCI. In addition, CABG was superior to MT for eliminating anginal symptoms. All three therapeutic regimens yielded relatively low rates of cardiac-related deaths.

Authors+Show Affiliations

Heart Institute of the University of São Paulo, São Paulo, Brazil. whady.hueb@incor.usp.brNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

15145093

Citation

Hueb, Whady, et al. "The Medicine, Angioplasty, or Surgery Study (MASS-II): a Randomized, Controlled Clinical Trial of Three Therapeutic Strategies for Multivessel Coronary Artery Disease: One-year Results." Journal of the American College of Cardiology, vol. 43, no. 10, 2004, pp. 1743-51.
Hueb W, Soares PR, Gersh BJ, et al. The medicine, angioplasty, or surgery study (MASS-II): a randomized, controlled clinical trial of three therapeutic strategies for multivessel coronary artery disease: one-year results. J Am Coll Cardiol. 2004;43(10):1743-51.
Hueb, W., Soares, P. R., Gersh, B. J., César, L. A., Luz, P. L., Puig, L. B., Martinez, E. M., Oliveira, S. A., & Ramires, J. A. (2004). The medicine, angioplasty, or surgery study (MASS-II): a randomized, controlled clinical trial of three therapeutic strategies for multivessel coronary artery disease: one-year results. Journal of the American College of Cardiology, 43(10), 1743-51.
Hueb W, et al. The Medicine, Angioplasty, or Surgery Study (MASS-II): a Randomized, Controlled Clinical Trial of Three Therapeutic Strategies for Multivessel Coronary Artery Disease: One-year Results. J Am Coll Cardiol. 2004 May 19;43(10):1743-51. PubMed PMID: 15145093.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - The medicine, angioplasty, or surgery study (MASS-II): a randomized, controlled clinical trial of three therapeutic strategies for multivessel coronary artery disease: one-year results. AU - Hueb,Whady, AU - Soares,Paulo R, AU - Gersh,Bernard J, AU - César,Luiz A M, AU - Luz,Protásio L, AU - Puig,Luiz B, AU - Martinez,Eulógio M, AU - Oliveira,Sergio A, AU - Ramires,José A F, PY - 2003/02/17/received PY - 2003/08/07/revised PY - 2003/08/15/accepted PY - 2004/5/18/pubmed PY - 2004/6/30/medline PY - 2004/5/18/entrez SP - 1743 EP - 51 JF - Journal of the American College of Cardiology JO - J Am Coll Cardiol VL - 43 IS - 10 N2 - OBJECTIVES: We sought to evaluate the relative efficacies of three possible therapeutic strategies for patients with multivessel coronary artery disease (CAD), stable angina, and preserved ventricular function. BACKGROUND: Despite routine use of coronary artery bypass graft surgery (CABG) and percutaneous coronary intervention (PCI), there is no conclusive evidence that either one is superior to medical therapy (MT) alone for the treatment of multivessel CAD. METHODS: The primary end point was defined as cardiac mortality, Q-wave myocardial infarction (MI), or refractory angina requiring revascularization. All data were analyzed according to the intention-to-treat principle. RESULTS: A total of 611 patients were randomly assigned to either a CABG (n = 203), PCI (n = 205), or MT (n = 203) group. The one-year survival rates were 96.0% for CABG, 95.6% for PCI, and 98.5% for MT. The rates for one-year survival free of Q-wave MI were 98% for CABG, 92% for PCI, and 97% for MT. After one-year follow-up, 8.3% of MT patients and 13.3% of PCI patients underwent to additional interventions, compared with only 0.5% of CABG patients. At one-year follow-up, 88% of the patients in the CABG group, 79% in the PCI group, and 46% in the MT group were free of angina (p < 0.0001). CONCLUSIONS: Medical therapy for multivessel CAD was associated with a lower incidence of short-term events and a reduced need for additional revascularization, compared with PCI. In addition, CABG was superior to MT for eliminating anginal symptoms. All three therapeutic regimens yielded relatively low rates of cardiac-related deaths. SN - 0735-1097 UR - https://www.unboundmedicine.com/medline/citation/15145093/The_medicine_angioplasty_or_surgery_study__MASS_II_:_a_randomized_controlled_clinical_trial_of_three_therapeutic_strategies_for_multivessel_coronary_artery_disease:_one_year_results_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0735109704004231 DB - PRIME DP - Unbound Medicine ER -