Document Detail


Outcomes of noncardiac surgery after coronary bypass surgery or coronary angioplasty in the Bypass Angioplasty Revascularization Investigation (BARI).
MedLine Citation:
PMID:  11239843     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
PURPOSE: Previous studies have shown that coronary artery bypass surgery reduces the risk of cardiac complications after noncardiac surgery. Whether coronary angioplasty provides equivalent protection is not known. SUBJECTS AND METHODS: Patients were randomly assigned to undergo cardiac artery bypass surgery or angioplasty as part of the Bypass Angioplasty Revascularization Investigation trial. All subsequent noncardiac surgeries during a mean (+/- SD) follow-up of 7.7 years were recorded among participants in the ancillary Study of Economics and Quality of Life. Rates of mortality and nonfatal myocardial infarction, length of stay, and hospital costs were compared by the original randomized assignment. RESULTS: A total of 501 patients had noncardiac surgery at a median of 29 months after their most recent coronary revascularization procedure. Mortality and nonfatal myocardial infarction within 30 days of the first noncardiac surgery occurred in 4 of the 250 of the surgery-assigned patients and in 4 of the 251 of the angioplasty-assigned patients (P = 1.0). There were no significant differences in the mean length of hospital stay (6.3 +/- 6.7 versus 6.2 +/- 6.8 days; P = 0.47) or hospital cost ($8,920 +/- $11,511 versus $7,785 +/- $7,643; P = 0.33) between the surgery and angioplasty groups. Similar results were obtained when subsequent noncardiac procedures were included in the analysis. CONCLUSION: Rates of myocardial infarction and death after noncardiac surgery are similarly low after contemporary bypass surgery or angioplasty in patients with multivessel coronary artery disease.
Authors:
S A Hassan; M A Hlatky; D B Boothroyd; C Winston; D B Mark; M M Brooks; K A Eagle
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The American journal of medicine     Volume:  110     ISSN:  0002-9343     ISO Abbreviation:  Am. J. Med.     Publication Date:  2001 Mar 
Date Detail:
Created Date:  2001-03-12     Completed Date:  2001-04-05     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  0267200     Medline TA:  Am J Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  260-6     Citation Subset:  AIM; IM    
Affiliation:
Henry Ford Hospital, Detroit, Michigan, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Angina Pectoris / prevention & control
Angioplasty, Transluminal, Percutaneous Coronary*
Coronary Artery Bypass*
Female
Humans
Male
Middle Aged
Myocardial Infarction / prevention & control
Postoperative Complications / prevention & control*
Recurrence
Risk
Risk Factors
Surgical Procedures, Operative / adverse effects*
Time Factors
Treatment Outcome
Grant Support
ID/Acronym/Agency:
HL-58324/HL/NHLBI NIH HHS
Comments/Corrections
Comment In:
Am J Med. 2001 Mar;110(4):320-3   [PMID:  11239855 ]

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


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