Is a strategy of intended incomplete percutaneous transluminal coronary angioplasty revascularization acceptable in nondiabetic patients who are candidates for coronary artery bypass graft surgery?: The bypass angioplasty revascularization investigation (BARI)☆

摘要: Abstract OBJECTIVES Our objective was to determine whether a strategy of intended incomplete percutaneous transluminal coronary angioplasty revascularization (IR) compromises long-term patient outcome. BACKGROUND Complete (CR) is often not planned nor attempted in patients with multivessel disease, and the extent which this influences outcome unclear. METHODS Before randomization, Bypass Angioplasty Revascularization Investigation, all angiograms were assessed for CR or IR via angioplasty. Outcomes compared among if assigned angioplasty, randomized artery bypass graft surgery (CABG) versus angioplasty; within only, intended. RESULTS At 5 years, there trend higher overall (88.6% vs. 84.0%) cardiac survival (94.5% 92.1%) CABG The excess mortality occurred solely diabetic subjects; similar nondiabetic patients. Freedom from myocardial infarction (MI) at years (92.4% 85.2%, p = 0.02), yet rate observed (85%) Five-year rates death, repeat angina However, greater freedom subsequent seen (70.3% 64.0%, 0.08). CONCLUSIONS Intended disease who are candidates both does compromise survival; however, need may be increased strategy. Whether risk MI also remains uncertain.