Document Detail


Clinical trials of coronary revascularization: coronary angioplasty vs. coronary bypass grafting.
MedLine Citation:
PMID:  11139092     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
In the absence of diabetes mellitus, rates of survival and of survival free of myocardial infarction (MI) are almost identical among patients with multivessel disease assigned to percutaneous transluminal coronary angioplasty (PTCA) versus those assigned to coronary artery bypass grafting (CABG) after 6.5 to 8 year follow-up period. Additional revascularization occurs 2.5 to 4.5 times more frequently in PTCA-treated than in CABG-treated patients and prevalence of angina is no longer statistically different between the two treatment groups. The excess health care costs of bypass surgery, which are important early after revascularization, almost disappear 5 to 8 years later. In patients with single vessel disease, survival free of MI is also comparable in both treatment groups at 5 years. Additional revasculariztion occurs two to four times more often in PTCA-treated than in CABG-treated patients and prevalence of angina does not differ between the two treatment groups. Thus, in nondiabetic patients with multivessel disease, the choice of a revascularization strategy rests on the patient's and treating physician's preference between the invasive nature of bypass surgery and the risk of recurrent procedures. In patients with single vessel disease, these long-term data suggest that bypass surgery is at least as safe and effective as coronary angioplasty and therefore may be a treatment option in selected cases.
Authors:
M G Bourassa
Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Review    
Journal Detail:
Title:  Current opinion in cardiology     Volume:  15     ISSN:  0268-4705     ISO Abbreviation:  Curr. Opin. Cardiol.     Publication Date:  2000 Jul 
Date Detail:
Created Date:  2001-01-02     Completed Date:  2001-03-29     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  8608087     Medline TA:  Curr Opin Cardiol     Country:  United States    
Other Details:
Languages:  eng     Pagination:  281-6     Citation Subset:  IM    
Affiliation:
Research Center, Montreal Heart Institute, Quebec, Canada. bourassa@icm.umontreal.ca
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MeSH Terms
Descriptor/Qualifier:
Angina Pectoris / diagnosis
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Artery Bypass*
Coronary Disease / economics,  mortality,  surgery*
Cost of Illness
Disease-Free Survival
Humans
Myocardial Infarction / diagnosis
Randomized Controlled Trials as Topic
Stents

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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