Similarity of ventricular function in patients alive 5 years after randomization to surgery or angioplasty in the BARI trial

Article

关键词: REVASCULARIZATION INVESTIGATION BARI;    MEDICALLY TREATED PATIENTS;    CORONARY-ARTERY SURGERY;    CASS REGISTRY;    SURVIVAL;    DISEASE;    SELECTION;    EXERCISE;   

DOI  :  10.1161/01.CIR.103.8.1076

来源: SCIE

【 摘 要 】

Background-Left ventricular ejection fraction (LVEF) is a recognized determinant of survival in patients with coronary artery disease. In major trials comparing surgical and percutaneous revascularization approaches, the long-term effect of the coronary revascularization strategy on LVEF has not been reported, Methods and Results-In the NHLBI-sponsored Bypass and Angioplasty Revascularization Investigation (BARI) randomized trial comparing angioplasty and bypass surgery as initial treatment strategies, 1220 (75%) of the 1617 surviving randomized patients had their EF measured by radionuclide ventriculography 5 years after study entry, For the total study group, the 5-year EF in the CABG group (n=623) was 55.8+/-12.3, compared with 55.7+/-12.7 in PTCA group (n=597, P=0.82). There was no significant difference in measured EF between the CABG group and the PTCA group within multiple subgroups determined by the presence or absence of diabetes, 3-vessel disease, complete revascularization, or prior myocardial infarction. In a multiple linear regression model developed to predict 5-year EF, treatment assignment to PTCA or CABG was not significant (P=0.95). If an EF of 0 was imputed for patients who were dead and missing EF data, however, there was a higher EF in the CABG group (P=0.0018) among diabetic patients only. Conclusions-In the BARI randomized trial, initial treatment assignment to angioplasty was not associated with any difference in long-term ventricular function compared with initial treatment assignment to surgery. These results apply, however, only to patients who were alive at 5 years.

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