Survival following coronary angioplasty vs. coronary artery bypass surgery in anatomic subsets in which coronary artery bypass surgery improves survival compared with medical therapy. Results from the bypass angioplasty revascularization investigation (BARI)

2012 ACCF/AHA/ACP/AATS/PCNA/SCAI/STS Guideline for the Diagnosis and Management of Patients With Stable Ischemic Heart Disease

“…1002 In several ways, these data are suboptimal, in that many studies compared CABG with balloon angioplasty, many were retrospective, and many were based on cohort or registry data. Some of the studies demonstrated a similar survival rate in patients having CABG and PCI, 988,1080,[1103][1104][1105] whereas others showed that those undergoing CABG had better outcomes. 964 The data that exist at present on revascularization in patients with CAD and LV systolic dysfunction are more robust for CABG than for PCI, although data from contemporary RCTs in this patient population are lacking.…”

2011 ACCF/AHA Guideline for Coronary Artery Bypass Graft Surgery

“…61,67,68 In addition, registry data and the results of meta-analyses have been used to assess the relative efficacies of the 2 techniques. 69,70 In 2005, an AHA Scientific statement comparing the 2 techniques concluded that both procedures usually result in excellent outcomes and that neither technique should be considered superior to the other. 71 At the same time, several differences were noted.…”

“…69,[72][73][74][75][76][77][78][79][80][81][82][83] A retrospective cohort study of 14 766 consecutive patients undergoing isolated CABG identified a mortality benefit (OR: 0.45) for off-pump CABG in patients with a predicted risk of mortality Ͼ2.5%, 82 but a subsequent randomized comparison of off-pump CABG to traditional on-pump CABG in 341 high-risk patients (a Euroscore Ͼ5) showed no difference in the composite endpoint of all-cause death, acute MI, stroke, or a required reintervention procedure. 78 An analysis of data from the New York State Cardiac Surgery Reporting system did not demonstrate a reduction in mortality rate with off-pump CABG in any patient subgroup, including the elderly (age Ͼ80 years) or those with cerebrovascular disease, azotemia, or an extensively calcified ascending aorta.…”

“…78 An analysis of data from the New York State Cardiac Surgery Reporting system did not demonstrate a reduction in mortality rate with off-pump CABG in any patient subgroup, including the elderly (age Ͼ80 years) or those with cerebrovascular disease, azotemia, or an extensively calcified ascending aorta. 69 Despite these results, off-pump CABG is the preferred approach by some surgeons who have extensive experience with it and therefore are comfortable with its technical nuances. Recently, published data suggested that the avoidance of aortic manipulation is the most important factor in reducing the risk of neurological complications.…”

Identification of proximal left anterior descending artery stenosis with thallium-201 defect patterns in patients with angina pectoris

“…[1][2][3][4][5] Although coronary angiography accurately localizes coronary stenosis, it is not routinely employed unless the need for coronary intervention is anticipated. Thus, a widely available noninvasive test that can identify proximal LAD stenosis could have substantial clinical utility.…”