Outcomes of noncardiac surgery after coronary bypass surgery or coronary angioplasty in the bypass angioplasty revascularization investigation (BARI)

A Clinical Randomized Trial to Evaluate the Safety of a Noninvasive Approach in High-Risk Patients Undergoing Major Vascular Surgery

“…This hypothesis was supported by the CASS study that showed a reduced incidence of nonfatal myocardial infarctions after previous bypass surgery among vascular surgery patients compared with those treated medically (8.5% vs. 0.6%, p ϭ 0.001) (4). More recently, the data from the BARI (Bypass Angioplasty Revascularization Investigation) trial showed that bypass surgery and PCI had similar low rates of postoperative cardiac events in noncardiac surgery (5). However, these studies were not designed to assign the optimal strategy in severely ill patients with extensive coronary artery disease immediately before major vascular surgery.…”

“…The current ACC/AHA recommendations are based on small observational, noncontrolled studies and expert opinion (4,5). The usefulness of the strategy of prophylactic revascularization was not confirmed by the recently completed CARP (Coronary Artery Revascularization Prophylaxis) randomized trial (6).…”

2009 ACCF/AHA Focused Update on Perioperative Beta Blockade Incorporated Into the ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery

“…In the Bypass Angioplasty Revascularization Investigation, patients with multivessel coronary disease were randomly assigned to undergo balloon angioplasty or CABG (319). In an ancillary study, the results of 1049 surgeries performed in 501 patients subsequent to randomization were analyzed; 250 patients had undergone CABG, and 251 had balloon angioplasty (312). The median time from the most recent coronary revascularization procedure to noncardiac surgery was 29 months.…”

ACC/AHA 2007 Guidelines on Perioperative Cardiovascular Evaluation and Care for Noncardiac Surgery

“…In the Bypass Angioplasty Revascularization Investigation, patients with multivessel coronary disease were randomly assigned to undergo balloon angioplasty or CABG (323). In an ancillary study, the results of 1049 surgeries performed in 501 patients subsequent to randomization were analyzed; 250 patients had undergone CABG, and 251 had balloon angioplasty (316). The median time from the most recent coronary revascularization procedure to noncardiac surgery was 29 months.…”