Probabilities of treatment effects in complete or culprit-only revascularization for NSTEMI a Bayesian re-analysis of the SLIM trial /

The completeness of revascularization in patients presenting with non-ST-elevation myocardial infarction (NSTEMI) and multivessel disease (MVD) remains understudied. The SLIM trial previously demonstrated a significant reduction in a composite endpoint of all-cause death, non-fatal myocardial infarc...

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Elmentve itt :
Bibliográfiai részletek
Szerzők: Heuts Samuel
Pustjens Tobias F S
Lux Árpad
Gabrio Andrea
van 't Hof Arnoud W J
Rasoul Saman
SLIM trial investigators
Veenstra Leo
Camaro Cyril
Ruiters Lex
Ruzsa Zoltán
Piroth Zsolt
Ilhan Mustafa
Vainer Jindrich
Gho Ben
Berta Balazs
Jambri Zoltan
et. al
Dokumentumtípus: Cikk
Megjelent: 2026
Sorozat:AMERICAN HEART JOURNAL 296
Tárgyszavak:
doi:10.1016/j.ahj.2026.107369

mtmt:36945589
Online Access:http://publicatio.bibl.u-szeged.hu/39847
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520 3 |a The completeness of revascularization in patients presenting with non-ST-elevation myocardial infarction (NSTEMI) and multivessel disease (MVD) remains understudied. The SLIM trial previously demonstrated a significant reduction in a composite endpoint of all-cause death, non-fatal myocardial infarction (MI), repeat revascularization, and stroke with complete revascularization under a frequentist framework. This post-hoc Bayesian re-analysis offers a probabilistic interpretation beyond conventional significance testing.The primary composite endpoint was analyzed as in the original trial, while secondary endpoints of the composite were evaluated individually. Analyses under multiple priors assessed robustness. The minimal clinically important difference (MCID) was defined as 5% absolute risk difference (ARD) for the composite endpoint and 1% for individual endpoints. The primary model used a weakly informative prior on the log relative risk (RR) scale within a normal-normal Bayesian framework.478 patients were randomized (complete: n=240; culprit-only: n=238). The posterior median RR for the composite endpoint was 0.41 (95% credible interval [CrI] 0.22-0.76), corresponding to an ARD of -7.9% (95%CrI -10.4% to -3.2%). The probability of any benefit was 99.8%, and the probability of meeting the MCID was 91.2%. For repeat revascularization, the ARD was -8.3% (95%CrI -10.0% to -4.5%), with a >99.9% probability of clinically relevant benefit. For non-fatal MI, the ARD was -2.8% (95%CrI -4.2% to 0.9%), with a 94.8% probability of benefit. Results were consistent across all priors.Complete revascularization provides a high probability of clinically meaningful benefit in NSTEMI patients with MVD, primarily through reductions in non-fatal MI and repeat revascularization. 
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700 0 1 |a Lux Árpad  |e aut 
700 0 1 |a Gabrio Andrea  |e aut 
700 0 2 |a van 't Hof Arnoud W J  |e aut 
700 0 2 |a Rasoul Saman  |e aut 
700 0 2 |a SLIM trial investigators  |e aut 
700 0 2 |a Veenstra Leo  |e aut 
700 0 2 |a Camaro Cyril  |e aut 
700 0 2 |a Ruiters Lex  |e aut 
700 0 2 |a Ruzsa Zoltán  |e aut 
700 0 2 |a Piroth Zsolt  |e aut 
700 0 2 |a Ilhan Mustafa  |e aut 
700 0 2 |a Vainer Jindrich  |e aut 
700 0 2 |a Gho Ben  |e aut 
700 0 2 |a Berta Balazs  |e aut 
700 0 2 |a Jambri Zoltan  |e aut 
700 0 2 |a et. al.  |e aut 
856 4 0 |u http://publicatio.bibl.u-szeged.hu/39847/1/Heuts2026.pdf  |z Dokumentum-elérés