Five-Year Outcomes After Coronary Stenting Versus Bypass Surgery for the Treatment of Multivessel Disease

Serruys, Patrick W.; Ong, Andrew T.L.; Herwerden, Lex A. van; Sousa, J. Eduardo; Jatene, Adib; Bonnier, J. J. R. M.; Schönberger, Jacques P.A.M.; Buller, Nigel; Bonser, Robert S.; Disco, Clemens; Backx, Bianca; Hugenholtz, Paul G.; Firth, Brian G.; Unger, Felix

doi:10.1016/j.jacc.2004.12.082

Cited by 541 publications

(46 citation statements)

References 10 publications

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“…The BARI trial results are consistent with those of recent clinical trials such as ARTS (Arterial Revascularization Therapies Study) (12), which reported comparable 5-year mortality for coronary bare-metal stenting and CABG (8.0% stents vs. 7.6% CABG), but more subsequent revascularization (30.3% vs. 8.8%) and more angina (21.2% vs. 15.5%) in the stenting group. Metaanalyses (13) and registries (14) based on larger and more diverse populations have shown small but statistically significant survival advantages with CABG at 3 to 5 years.…”

Section: Discussionsupporting

confidence: 84%

The Final 10-Year Follow-Up Results From the BARI Randomized Trial

Investigators¹

2007

Journal of the American College of Cardiology

381

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Section: Discussionsupporting

confidence: 84%

The Final 10-Year Follow-Up Results From the BARI Randomized Trial

Investigators¹

2007

Journal of the American College of Cardiology

381

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“…Thus patients underwent concomitant treatment of multiple vessels during the same hospitalization. The good results in the present series are to be noted in the case of complete revascularization in patients with multivessel coronary artery disease, compared to results reported for surgery or PCI alone [19,20,21]. Compared to other hybrid revascularization series involving right coronary stenting [22,23,24], our follow-up results were very satisfactory.…”

Section: Discussionsupporting

confidence: 60%

Same-Day Combined Percutaneous Coronary Intervention and Coronary Artery Surgery

Gilard¹,

Bezon

Cornily³

et al. 2007

Cardiology

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“…The same results were observed in the Arterial Revascularization Therapies Study (ARTS), which compared bare metal stenting with CABG, even though the mortality rates in the PCI group were smaller (8%) than those in the MASS II PCI group. 12 This difference in the PCI group could be due to the more serious clinical characteristics of our population, with a higher incidence of risk factors and a higher incidence of triple-vessel disease, with 93% of proximal left anterior descending coronary artery involvement, compared with the ARTS population (58% and 30%, respectively). Furthermore, in ARTS, the major adverse cardiac events were higher in the stent group, driven by the increased need for additional revascularization; similar results were found in MASS II.…”

Section: Discussionmentioning

confidence: 82%

Five-Year Follow-Up of the Medicine, Angioplasty, or Surgery Study (MASS II)

et al. 2007

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Background-Despite routine use of coronary artery bypass graft (CABG) and percutaneous coronary intervention (PCI), no conclusive evidence exists that either modality is superior to medical therapy (MT) alone for treating multivessel coronary artery disease with stable angina and preserved ventricular function. Methods and Results-The primary end points were total mortality, Q-wave myocardial infarction, or refractory angina requiring revascularization. The study comprised 611 patients randomly assigned to undergo CABG (nϭ203), PCI (nϭ205), or MT (nϭ203). At the 5-year follow-up, the primary end points occurred in 21.2% of patients who underwent CABG compared with 32.7% treated with PCI and 36% receiving MT alone (Pϭ0.0026). No statistical differences were observed in overall mortality among the 3 groups. In addition, 9.4% of MT and 11.2% of PCI patients underwent repeat revascularization procedures compared with 3.9% of CABG patients (Pϭ0.021). Moreover, 15.3%, 11.2%, and 8.3% of patients experienced nonfatal myocardial infarction in the MT, PCI, and CABG groups, respectively (PϽ0.001). The pairwise treatment comparisons of the primary end points showed no difference between PCI and MT (relative risk, 0.93; 95% confidence interval, 0.67 to 1.30) and a significant protective effect of CABG compared with MT (relative risk, 0.53; 95% confidence interval, 0.36 to 0.77). Conclusions-All 3 treatment regimens yielded comparable, relatively low rates of death. MT was associated with an incidence of long-term events and rate of additional revascularization similar to those for PCI. CABG was superior to MT in terms of the primary end points, reaching a significant 44% reduction in primary end points at the 5-year follow-up of patients with stable multivessel coronary artery disease.

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Five-Year Outcomes After Coronary Stenting Versus Bypass Surgery for the Treatment of Multivessel Disease

Cited by 541 publications

References 10 publications

The Final 10-Year Follow-Up Results From the BARI Randomized Trial

The Final 10-Year Follow-Up Results From the BARI Randomized Trial

Same-Day Combined Percutaneous Coronary Intervention and Coronary Artery Surgery

Five-Year Follow-Up of the Medicine, Angioplasty, or Surgery Study (MASS II)

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