Document Detail

13-year follow-up of the German angioplasty bypass surgery investigation.
MedLine Citation:
PMID:  15975991     Owner:  NLM     Status:  MEDLINE    
AIMS: The German Angioplasty Bypass Surgery Investigation was designed to compare symptomatic efficacy and safety of percutaneous coronary balloon angioplasty (PTCA) with coronary artery bypass surgery (CABG) in patients with symptomatic multi-vessel disease. This follow-up study was performed to determine the long-term outcome of patients following these interventions. METHODS AND RESULTS: From 1986 to 1991, 359 patients with angina CCS class II-IV, age below 75 years, and coronary multi-vessel disease requiring revascularization of at least two major coronary vessels were recruited at eight German centres and randomized to PTCA or CABG. From 337 patients undergoing the planned procedure, 324 patients could be followed-up (96%). Baseline parameters were identical in both groups, 2.2+/-0.6 vessels were treated in CABG patients, whereas 1.9+/-0.5 vessels were treated in PTCA patients. Thirty-seven per cent of surgical patients received internal mammary artery grafts, while no stents were used in patients undergoing PTCA. At the end of the 13-year follow-up period, the degree of angina, the degree of dyspnea, and the utilization of nitrates were comparable in both groups. With a total number of 76 deaths, Kaplan-Meier analysis revealed a comparable distribution in both groups. Although time to first re-intervention was significantly shorter in the PTCA group, P<0.001, frequencies of re-intervention (CABG, n=94; PTCA, n=136) and crossover rates (CABG to PTCA, n=49; PTCA to CABG, n=51) were comparable in both groups. CONCLUSION: The results of our 13-year follow-up suggest that in patients with symptomatic multi-vessel disease, both PTCA and CABG are associated with a comparable long-term survival and symptomatic efficacy. How far these results may be altered by developments such as drug-eluting stents or off-pump surgery remains to be determined.
Jan Kaehler; Ralf Koester; Wibke Billmann; Christian Schroeder; Hans-Jürgen Rupprecht; Thomas Ischinger; Roland Jahns; Albrecht Vogt; Martin Lampen; Rainer Hoffmann; Reimer Riessen; Joachim Berger; Thomas Meinertz; Christian W Hamm
Publication Detail:
Type:  Comparative Study; Journal Article; Multicenter Study; Randomized Controlled Trial; Research Support, Non-U.S. Gov't     Date:  2005-06-23
Journal Detail:
Title:  European heart journal     Volume:  26     ISSN:  0195-668X     ISO Abbreviation:  Eur. Heart J.     Publication Date:  2005 Oct 
Date Detail:
Created Date:  2005-09-30     Completed Date:  2006-03-21     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8006263     Medline TA:  Eur Heart J     Country:  England    
Other Details:
Languages:  eng     Pagination:  2148-53     Citation Subset:  IM    
Department of Cardiology, University Hospital Hamburg, Martinistrasse 52, 20246 Hamburg, Germany.
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MeSH Terms
Angina Pectoris / etiology,  mortality,  therapy*
Angioplasty, Transluminal, Percutaneous Coronary / methods*,  mortality
Coronary Artery Bypass / methods*,  mortality
Coronary Stenosis / mortality,  therapy*
Follow-Up Studies
Middle Aged
Myocardial Infarction / mortality,  therapy
Myocardial Revascularization / methods,  mortality
Treatment Outcome

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