Is five-year mortality different for treatment by choice vs. random assignment in the bypass angioplasty revascularization investigation (BARI)?

Detre, Katherine M.; Rosen, Allan D.; Jones, Robert; Rogers, William J.; Mock, Michael B.; Faxon, David P.; Bourassa, Martial G.; Feit, Frederick; Cowley, Michael J.; Loop, Floyd D.; Investigators, Bari D

doi:10.1016/s0735-1097(96)81848-1

Cited by 4 publications

(1 citation statement)

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“…Treated patients with diabetes in the BARI registry who refused randomization and selected their form of revascularization did not fare worse with PTCA (144). In a retrospective cohort study comparing PTCA and CABG for patients with diabetes with multivessel disease and similar age, sex, EF, and severity of angina, there was also no difference in survival after 6 years (145).…”

Section: Results From Nonrandomized Trials and Registriesmentioning

confidence: 99%

ACC/AHA 2004 guideline update for coronary artery bypass graft surgery

Wilkins¹

2004

Journal of the American College of Cardiology

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Section: Results From Nonrandomized Trials and Registriesmentioning

confidence: 99%

ACC/AHA 2004 guideline update for coronary artery bypass graft surgery

Wilkins¹

2004

Journal of the American College of Cardiology

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ACC/AHA guidelines for coronary artery bypass graft surgery

Eagle¹,

Guyton²,

Davidoff³

et al. 1999

Journal of the American College of Cardiology

757

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Influence of Diabetes on 5-Year Mortality and Morbidity in a Randomized Trial Comparing CABG and PTCA in Patients With Multivessel Disease

Investigators

1997

Circulation

521

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Background Patients with diabetes mellitus have increased morbidity and mortality after coronary revascularization. The Bypass Angioplasty Revascularization Investigation (BARI), a trial of percutaneous transluminal coronary angioplasty (PTCA) versus coronary artery bypass graft surgery (CABG) in patients with multivessel disease, reported a 5-year survival advantage of CABG over PTCA in patients with treated diabetes mellitus (TDM). This report examines these findings in more detail. Methods and Results Eighteen clinical centers randomly assigned 1829 patients with multivessel coronary disease to undergo initial CABG or PTCA. Patients were followed an average of 5.4 years. TDM was defined as a history of diabetes with use of oral hypoglycemic agents or insulin at study entry. Nineteen percent of the randomized population (353 patients) met these criteria. TDM patients had more unfavorable baseline characteristics than other patients, but among TDM patients, these characteristics were similar between the CABG and PTCA groups. Better average 5.4-year survival with CABG was due to reduced cardiac mortality (5.8% versus 20.6%, P =.0003), which was confined to those receiving at least one internal mammary artery graft. Conclusions Patients with TDM assigned to an initial strategy of CABG have a striking reduction in cardiac mortality compared with PTCA. Long-term internal mammary artery graft patency may contribute to this improved outcome by reducing the fatality of follow-up myocardial infarction.

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Is five-year mortality different for treatment by choice vs. random assignment in the bypass angioplasty revascularization investigation (BARI)?

Cited by 4 publications

References 0 publications

ACC/AHA 2004 guideline update for coronary artery bypass graft surgery

ACC/AHA 2004 guideline update for coronary artery bypass graft surgery

ACC/AHA guidelines for coronary artery bypass graft surgery

Influence of Diabetes on 5-Year Mortality and Morbidity in a Randomized Trial Comparing CABG and PTCA in Patients With Multivessel Disease

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