Bypass Angioplasty Revascularization Investigation

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]


Bypass angioplasty revascularization investigation

The two U.S. trials of PTCA versus CABG are the multicenter Bypass Angioplasty Revascularization Investigation (BARI) trial[1] and the single-center Emory Angioplasty Surgery Trial (EAST)[2].

In both trials, a majority of patients had two- rather than three-vessel disease and normal LV function. In the BARI trial, 37% of patients had a proximal LAD lesion. The results of BARI trial at seven year follow-up interval has shown that early and late survival rates have been equivalent for the PTCA and CABG groups. The subgroup of patients with treated diabetes had a significantly better survival rate with CABG. That survival advantage for CABG was focused in the group of diabetic patients with multiple severe lesions. The biggest difference in late outcomes was the need for repeat revascularization procedures and symptom status. 54% of PTCA patients underwent subsequent revascularization procedures during the five-year follow-up versus 8% of the CABG group. In addition, the rate of freedom from angina was better in the CABG group and fewer patients in the CABG groups needed to take anti-anginal medications.

Related Chapters


  1. Comparison of coronary bypass surgery with angioplasty in patients with multivessel disease. The Bypass Angioplasty Revascularization Investigation (BARI) Investigators. N Engl J Med. 1996 Jul 25;335(4):217-25. Erratum in: N Engl J Med 1997 Jan 9;336(2):147. PMID: 8657237
  2. Eight-year mortality in the Emory Angioplasty versus Surgery Trial (EAST) King SB 3rd, Kosinski AS, Guyton RA, Lembo NJ, Weintraub WS. J Am Coll Cardiol. 2000 Apr;35(5):1116-21. PMID: 10758949