In Brief: PTCA v. CABG
This article was originally published in The Gray Sheet
Executive Summary
PTCA v. CABG: Investigators in the 1,829-patient, randomized BARI trial report "no significant difference" by treatment strategy in five-year survival, as well as survival free of myocardial infarction, between multivessel coronary artery disease patients treated with percutaneous transluminal coronary angioplasty and those treated with coronary artery bypass grafting. The study -- funded by the National Heart, Lung and Blood Institute -- also found a "trend of better survival" among bypass patients, but determined that the trend was accounted for by "excess mortality among treated diabetics assigned to an initial PTCA strategy." A cost analysis of the two procedures found that "average overall costs were 4% higher for a strategy of initial coronary artery bypass," leading to average savings of $2,000 with PTCA...