Evidence map›Paper›PMID 40439159›Full record

Trial reportEuropean heart journal2025

Optimal medical care and coronary flow capacity-guided myocardial revascularization vs usual care for chronic coronary artery disease: the CENTURY trial.

K Lance Gould, Nils P Johnson, Amanda E Roby, Richard Kirkeeide, Mary Haynie, Tung Nguyen, Linh Bui, Monica B Patel, Danai Kitkungvan, Patricia Mendoza and 5 more

Erratum issued Registry-linked trialAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in European heart journal, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. It is linked to trial NCT00756379 (Randomized Trial of Comprehensive Lifestyle Modifications, Optimal Pharmacological Treatment and PET Imaging for Detection and Management of Stable Coronary Artery Disease), which is not on this map. Cited by 4 papers.

0numbers the graph read from it
0cells of the map it votes in
4citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00756379 naactive not recruitingnot on this map

Randomized Trial of Comprehensive Lifestyle Modifications, Optimal Pharmacological Treatment and PET Imaging for Detection and Management of Stable Coronary Artery Disease

TypeinterventionalSponsorThe University of Texas Health Science Center, HoustonRan2009 to 2027Enrolled1,085ConditionsCardiovascular Disease, Atherosclerosis, Coronary Artery Disease, Coronary StenosisArmsComprehensive therapy program for risk factor modification
3 · Its place in the literature

Who cites it

4 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
  4. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

15 authors.

K Lance GouldWeatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas McGovern Medical School, 6431 Fannin St., Room MSB 4.256, and Memorial Hermann Hospital, Houston, TX 77030, USA.ORCID 0000-0003-4019-5941
Nils P JohnsonWeatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas McGovern Medical School, 6431 Fannin St., Room MSB 4.256, and Memorial Hermann Hospital, Houston, TX 77030, USA.ORCID 0000-0002-0897-2301
Amanda E RobyWeatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas McGovern Medical School, 6431 Fannin St., Room MSB 4.256, and Memorial Hermann Hospital, Houston, TX 77030, USA.
Richard KirkeeideWeatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas McGovern Medical School, 6431 Fannin St., Room MSB 4.256, and Memorial Hermann Hospital, Houston, TX 77030, USA.
Mary HaynieWeatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas McGovern Medical School, 6431 Fannin St., Room MSB 4.256, and Memorial Hermann Hospital, Houston, TX 77030, USA.
Tung NguyenWeatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas McGovern Medical School, 6431 Fannin St., Room MSB 4.256, and Memorial Hermann Hospital, Houston, TX 77030, USA.
Linh BuiWeatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas McGovern Medical School, 6431 Fannin St., Room MSB 4.256, and Memorial Hermann Hospital, Houston, TX 77030, USA.
Monica B PatelWeatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas McGovern Medical School, 6431 Fannin St., Room MSB 4.256, and Memorial Hermann Hospital, Houston, TX 77030, USA.
Danai KitkungvanWeatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas McGovern Medical School, 6431 Fannin St., Room MSB 4.256, and Memorial Hermann Hospital, Houston, TX 77030, USA.
Patricia MendozaWeatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas McGovern Medical School, 6431 Fannin St., Room MSB 4.256, and Memorial Hermann Hospital, Houston, TX 77030, USA.
Dejian LaiDepartment of Biostatistics and Data Science, University of Texas School of Public Health, Houston, TX, USA.
Ruosha LiDepartment of Biostatistics and Data Science, University of Texas School of Public Health, Houston, TX, USA.ORCID 0000-0003-3595-4392
Stefano SdringolaWeatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas McGovern Medical School, 6431 Fannin St., Room MSB 4.256, and Memorial Hermann Hospital, Houston, TX 77030, USA.
David McPhersonWeatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas McGovern Medical School, 6431 Fannin St., Room MSB 4.256, and Memorial Hermann Hospital, Houston, TX 77030, USA.
Jagat NarulaWeatherhead PET Center for Preventing and Reversing Atherosclerosis, Division of Cardiology, Department of Medicine, University of Texas McGovern Medical School, 6431 Fannin St., Room MSB 4.256, and Memorial Hermann Hospital, Houston, TX 77030, USA.ORCID 0000-0002-0280-3996

Funding

University of Texas-Houston
6 · The paper itself

Abstract

BACKGROUND AND

aimsThe randomized CENTURY trial tested the hypothesis that a comprehensive strategy integrating intense lifestyle modification and aggressive medical management to goals with revascularization reserved for severely reduced coronary flow capacity (CFC) by positron emission tomography (PET) would reduce risk factors, subsequent revascularization, death and myocardial infarction (MI) compared with standard of care in chronic stable coronary artery disease (CAD).

methodsParticipants were randomly assigned to standard or comprehensive care groups. Rest-stress PET quantified CFC for physiological CAD severity at baseline, 2, 5, and up to 11 years. The comprehensive care group reviewed PET results with frequent clinic visits and open 24/7 phone/email support. Standard care lacked supportive contact with blinded PET results that were unblinded only for severely reduced CFC with high mortality risk for potential revascularization.

resultsBetween 2009-2017, 515 patients were assigned to comprehensive care and 513 to standard care and followed for 5 or more years. Comprehensive vs standard care decreased risk factors and summed 5-year risk score (Δ-1.1 vs + 0.33; 95% confidence interval -1.84 to -0.97; P < .0001), decreased cumulative 11-year all-cause death (4.7% vs 8.2%; P = .023), death or MI (7.0% vs 11.1%; P = .024) late revascularization (9.5% vs 14.8%; P = .021) and major adverse cardiac events (20.5% vs 29.9%; P = .0006). Only 56 of 1028 (5.4%) CENTURY patients with chronic CAD had revascularization within 90 days predominantly guided by CFC severity.

conclusionsThe randomized CENTURY trial demonstrates that comprehensive integrated lifestyle modification and medical management towards goals with revascularization reserved for severely reduced CFC, significantly reduced risk factor scores, death, death or MI, and revascularization. CLINICALTRIALS.GOV: NCT00756379.

Indexed as

Coronary Artery DiseaseMyocardial RevascularizationAgedChronic DiseaseCoronary CirculationFemaleHumansMaleMiddle AgedMyocardial InfarctionPositron-Emission TomographyRisk FactorsChronic stable coronary syndromesCoronary flow capacityCoronary flow reserveCoronary revascularizationLifestyle modificationOptimal medical therapyPositron emission tomography

Identifiers

PMID40439159
PMCPMC12401582

What Socratic holds

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LicenceCC BY
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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the Socratic graph.