Author + information
- Received November 9, 1992
- Revision received March 31, 1993
- Accepted April 7, 1993
- Published online October 1, 1993.
- Alfredo Rodriguez, MD∗,
- Fernando Boullon, MD∗,
- Nestor Perez-Baliño, MD, FACC∗,
- Claudia Paviotti, MD∗,
- Maria I.Sosa Liprandi, MD∗,
- Igor F. Palacios, MD, FACC∗∗,b,
- The ERACI Group†
- ↵∗Address for correspondence: Igor F. Palacios, MD, Director of Interventional Cardiology, Cardiac Unit, Massachusetts General Hospital, Boston, Massachusetts 02114.
Objectives. This study was designed to compare freedom from combined cardiac events (death, angina, myocardial infarction) at 1-, 3- and 5-year follow-up in patients with multivessel disease randomized to either percutaneous transluminal coronary angioplasty or coronary artery bypass graft surgery.
Background. Percutaneous transluminal coronary angioplasty has been an effective approach in patients with coronary artery disease, but its role in patients with multivessel coronary artery disease is still controversial.
Methods. One-hundred twenty-seven patients with multivessel disease and lesions suitable for either form of therapy were randomized to either coronary artery bypass grafting (n = 64) or coronary angioplasty (n = 63). In this study we report the immediate results and freedom from combined cardiac events at 1-year follow-up.
Results. Demographic, clinical and angiographic characteristics were similar in both groups. There were no differences in in-hospital deaths, frequency of periprocedure myocardial infarction or need for emergency revascularization procedures between the two groups. At 1-year follow-up, there were no differences in mortality or in the incidence of myocardial infarction between the groups. However, patients treated with coronary artery bypass grafting were more frequently free of angina, reinterventions and combined cardiac events than were patients treated with coronary angioplasty (83.5% vs. 63.7%, p < 0.005). In-hospital cost and cumulative cost at 1-year follow-up were greater for the coronary artery bypss grafting than for the coronary angioplasty group.
Conclusions. No significant differences were found in major in-hospital complications between patients treated with coronary artery bypass grafting or coronary angioplasty. Although at 1-year follow-up there were no differences in survival and freedom from myocardial infarction, patients in the coronary artery bypass grafting group were more frequently free from angina, reinterventions and combined events than were patients in the coronary angioplasty group.
↵† A complete list of the ERACI Group investigators appears in the Appendix.
☆ This study was presented in part at the 41st Annual Scientific Sessions of the American College of Cardiology, Dallas, Texas, April 1992.
- Received November 9, 1992.
- Revision received March 31, 1993.
- Accepted April 7, 1993.