Quantitative PET coronary flow capacity and comprehensive management of chronic CAD: Lessons from the randomized CENTURY trial.
Comprehensive positron emission tomography-guided care cut major adverse cardiac events versus standard care.
Quantitative PET coronary flow capacity and comprehensive management of chronic CAD: Lessons from the randomized CENTURY trial.
Randomized trials in chronic coronary artery disease (coronary artery disease) tested single interventions of lifestyle, medical treatment, or revascularization.
With high risk factors, suspected or known coronary artery disease were randomly assigned to comprehensive or standard care.
major heart complications less common with positron emission tomography-guided care
Of 1028 randomized participants, 515 were assigned to comprehensive care and 513 to standard care for the 5-year protocol with additional follow-up over next 5 to 11 years.
Only 56 of 1028 (5.4%) CENTURY patients had revascularization within 90 days guided by coronary flow capacity severity, thereby reassuring and motivating patients and physicians for safely pursuing preventive risk factor goals while reserving angiogram-revascularization for high-risk, severe coronary flow capacity.
The randomised CENTURY trial demonstrates that comprehensive integrated lifestyle modification and optimal medical treatment with revascularization reserved for severely reduced coronary flow capacity significantly reduced death, death or MI, and revascularization at 5 years and potentially over extended 5 to 11 years of non-predefined follow-up.
(ClinicalTrials.gov NCT00756379).