{"id":"9a46ceb2f3d6","type":"article","url":"https://hartvaat.nl/2026/02/10/spontaan-myocardinfarct-na-linkerhoofdstamrevascularisatie-de-excel-trial/","title":"Spontaan myocardinfarct na linkerhoofdstamrevascularisatie: de EXCEL-trial","title_en":"Spontaneous Myocardial Infarction After Left Main Revascularization: The EXCEL Trial","category":"algemeen","category_label":"Algemeen","professions":["cardioloog"],"tags":["acuut-hartfalen","anemie-ckd","aperitif-trial","bloeddrukbehandeling","colcot-trial","kanker-en-hart","myocardinfarct","ouderen"],"journal":"Circulation","doi":"https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.075875","source_url":"https://doi.org/https://www.ahajournals.org/doi/abs/10.1161/CIRCULATIONAHA.125.075875","authors":[],"significance":8,"published":"2026-02-10","source_date":"2026-02-10","image":"","kennis":["https://hartvaat.nl/kennis/coronairlijden/stemi/","https://hartvaat.nl/kennis/coronairlijden/pci-vs-cabg-afweging/"],"congress":"","summary_en":"This EXCEL analysis compared rates and prognostic implications of spontaneous MI after PCI versus CABG for left main disease, providing granular data on the long-term ischemic risk profile of each revascularization strategy.","created":"2026-07-03T10:25:23Z","updated":"2026-07-03T13:24:49Z","licence":"Citeer vrij, met bronvermelding en een link naar hartvaat.nl (de url van het record). Samenvattingen zijn redactioneel werk van HartVaat; de oorspronkelijke publicaties blijven van hun uitgevers (doi). Geen medisch advies.","body_markdown":"Er zijn beperkte gegevens over het spontane myocardinfarctenrisico na PCI versus CABG bij linkerhoofdstamziekte. Deze analyse van de EXCEL-trial onderzocht de relatieve frequentie, etiologie en langetermijnprognose.","abstract_original":"BACKGROUND:Limited data are available regarding the relative rates, etiology, and long-term prognostic implications of spontaneous myocardial infarction (MI) after percutaneous coronary intervention (PCI) versus coronary artery bypass graft (CABG) surgery for left main coronary artery disease (LMCAD).METHODS:MIs after PCI and CABG for LMCAD were adjudicated from the EXCEL trial (Evaluation of Xience Versus Coronary Artery Bypass Surgery for Effectiveness of Left Main Revascularization). Cox proportional hazards regression was performed to assess the association between spontaneous (and procedural) MI and cardiovascular and all-cause mortality at 5 years.RESULTS:Among 1882 patients who underwent LMCAD revascularization, spontaneous MI during 5-year follow-up occurred in 60 (6.8%) patients after PCI and in 29 (3.4%) patients after CABG (adjusted hazard ratio [adjHR], 2.01; 95 CI, 1.29–3.15;P=0.002). By multivariable analysis, spontaneous MI (as a time-adjusted covariate) was a strong ind"}