Percutaneous coronary intervention versus coronary artery bypass graft surgery for patients with medically refractory myocardial ischemia and risk factors for adverse outcomes with bypass: A multicenter, randomized trial

Douglass A. Morrison, Gulshan Sethi, Jerome Sacks, William Henderson, Frederick Grover, Steven Sedlis, Rick Esposito, K Ramanathan, Darryl Weiman, Jorge Saucedo, Tamim Antakli, Venki Paramesh, Stuart Pert, Sarah Vernon, Vladimir Birjiniuk, Frederick Welt, Mitchell Krucoff, Walter Wolfe, John C. Lucke, Sundeep MedirattaDavid Booth, Charles Barbiere, Daniel Lewis

Research output: Contribution to journalArticle

217 Citations (Scopus)

Abstract

BACKGROUND: Percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG) are being applied to high-risk populations, but previous randomized trials comparing revascularization methods have excluded a number of important high-risk groups. OBJECTIVES: This five-year, multicenter, randomized clinical trial was designed to compare long-term survival among patients with medically refractory myocardial ischemia and a high risk of adverse outcomes assigned to either a CABG or a PCI strategy, which could include stents. METHODS: Patients from 16 Veterans Affairs Medical Centers were screened to identify myocardial ischemia refractory to medical management and the presence of one or more risk factors for adverse outcome with CABG, including prior open-heart surgery, age >70 years, left ventricular ejection fraction <0.35, myocardial infarction within seven days or intraaortic balloon pump required. Clinically eligible patients (n = 2,431) underwent coronary angiography; 781 were angiographically acceptable; 454 (58% of eligible) patients consented to random assignment between CABG and PCI. RESULTS: A total of 232 patients was randomized to CABG and 222 to PCI. The 30-day survivals for CABG and PCI were 95% and 97%, respectively. Survival rates for CABG and PCI were 90% versus 94% at six months and 79% versus 80% at 36 months (log-rank test, p = 0.46). CONCLUSIONS: Percutaneous coronary intervention is an alternative to CABG for patients with medically refractory myocardial ischemia and a high risk of adverse outcomes with CABG.

Original languageEnglish (US)
Pages (from-to)143-149
Number of pages7
JournalJournal of the American College of Cardiology
Volume38
Issue number1
DOIs
StatePublished - Jul 16 2001
Externally publishedYes

Fingerprint

Percutaneous Coronary Intervention
Coronary Artery Bypass
Multicenter Studies
Myocardial Ischemia
Transplants
Survival
Veterans
Coronary Angiography
Stroke Volume
Thoracic Surgery
Stents
Survival Rate
Randomized Controlled Trials
Myocardial Infarction

All Science Journal Classification (ASJC) codes

  • Cardiology and Cardiovascular Medicine

Cite this

Percutaneous coronary intervention versus coronary artery bypass graft surgery for patients with medically refractory myocardial ischemia and risk factors for adverse outcomes with bypass : A multicenter, randomized trial. / Morrison, Douglass A.; Sethi, Gulshan; Sacks, Jerome; Henderson, William; Grover, Frederick; Sedlis, Steven; Esposito, Rick; Ramanathan, K; Weiman, Darryl; Saucedo, Jorge; Antakli, Tamim; Paramesh, Venki; Pert, Stuart; Vernon, Sarah; Birjiniuk, Vladimir; Welt, Frederick; Krucoff, Mitchell; Wolfe, Walter; Lucke, John C.; Mediratta, Sundeep; Booth, David; Barbiere, Charles; Lewis, Daniel.

In: Journal of the American College of Cardiology, Vol. 38, No. 1, 16.07.2001, p. 143-149.

Research output: Contribution to journalArticle

Morrison, DA, Sethi, G, Sacks, J, Henderson, W, Grover, F, Sedlis, S, Esposito, R, Ramanathan, K, Weiman, D, Saucedo, J, Antakli, T, Paramesh, V, Pert, S, Vernon, S, Birjiniuk, V, Welt, F, Krucoff, M, Wolfe, W, Lucke, JC, Mediratta, S, Booth, D, Barbiere, C & Lewis, D 2001, 'Percutaneous coronary intervention versus coronary artery bypass graft surgery for patients with medically refractory myocardial ischemia and risk factors for adverse outcomes with bypass: A multicenter, randomized trial', Journal of the American College of Cardiology, vol. 38, no. 1, pp. 143-149. https://doi.org/10.1016/S0735-1097(01)01366-3
Morrison, Douglass A. ; Sethi, Gulshan ; Sacks, Jerome ; Henderson, William ; Grover, Frederick ; Sedlis, Steven ; Esposito, Rick ; Ramanathan, K ; Weiman, Darryl ; Saucedo, Jorge ; Antakli, Tamim ; Paramesh, Venki ; Pert, Stuart ; Vernon, Sarah ; Birjiniuk, Vladimir ; Welt, Frederick ; Krucoff, Mitchell ; Wolfe, Walter ; Lucke, John C. ; Mediratta, Sundeep ; Booth, David ; Barbiere, Charles ; Lewis, Daniel. / Percutaneous coronary intervention versus coronary artery bypass graft surgery for patients with medically refractory myocardial ischemia and risk factors for adverse outcomes with bypass : A multicenter, randomized trial. In: Journal of the American College of Cardiology. 2001 ; Vol. 38, No. 1. pp. 143-149.
@article{3b9776294d074521ab1795e284973d60,
title = "Percutaneous coronary intervention versus coronary artery bypass graft surgery for patients with medically refractory myocardial ischemia and risk factors for adverse outcomes with bypass: A multicenter, randomized trial",
abstract = "BACKGROUND: Percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG) are being applied to high-risk populations, but previous randomized trials comparing revascularization methods have excluded a number of important high-risk groups. OBJECTIVES: This five-year, multicenter, randomized clinical trial was designed to compare long-term survival among patients with medically refractory myocardial ischemia and a high risk of adverse outcomes assigned to either a CABG or a PCI strategy, which could include stents. METHODS: Patients from 16 Veterans Affairs Medical Centers were screened to identify myocardial ischemia refractory to medical management and the presence of one or more risk factors for adverse outcome with CABG, including prior open-heart surgery, age >70 years, left ventricular ejection fraction <0.35, myocardial infarction within seven days or intraaortic balloon pump required. Clinically eligible patients (n = 2,431) underwent coronary angiography; 781 were angiographically acceptable; 454 (58{\%} of eligible) patients consented to random assignment between CABG and PCI. RESULTS: A total of 232 patients was randomized to CABG and 222 to PCI. The 30-day survivals for CABG and PCI were 95{\%} and 97{\%}, respectively. Survival rates for CABG and PCI were 90{\%} versus 94{\%} at six months and 79{\%} versus 80{\%} at 36 months (log-rank test, p = 0.46). CONCLUSIONS: Percutaneous coronary intervention is an alternative to CABG for patients with medically refractory myocardial ischemia and a high risk of adverse outcomes with CABG.",
author = "Morrison, {Douglass A.} and Gulshan Sethi and Jerome Sacks and William Henderson and Frederick Grover and Steven Sedlis and Rick Esposito and K Ramanathan and Darryl Weiman and Jorge Saucedo and Tamim Antakli and Venki Paramesh and Stuart Pert and Sarah Vernon and Vladimir Birjiniuk and Frederick Welt and Mitchell Krucoff and Walter Wolfe and Lucke, {John C.} and Sundeep Mediratta and David Booth and Charles Barbiere and Daniel Lewis",
year = "2001",
month = "7",
day = "16",
doi = "10.1016/S0735-1097(01)01366-3",
language = "English (US)",
volume = "38",
pages = "143--149",
journal = "Journal of the American College of Cardiology",
issn = "0735-1097",
publisher = "Elsevier USA",
number = "1",

}

TY - JOUR

T1 - Percutaneous coronary intervention versus coronary artery bypass graft surgery for patients with medically refractory myocardial ischemia and risk factors for adverse outcomes with bypass

T2 - A multicenter, randomized trial

AU - Morrison, Douglass A.

AU - Sethi, Gulshan

AU - Sacks, Jerome

AU - Henderson, William

AU - Grover, Frederick

AU - Sedlis, Steven

AU - Esposito, Rick

AU - Ramanathan, K

AU - Weiman, Darryl

AU - Saucedo, Jorge

AU - Antakli, Tamim

AU - Paramesh, Venki

AU - Pert, Stuart

AU - Vernon, Sarah

AU - Birjiniuk, Vladimir

AU - Welt, Frederick

AU - Krucoff, Mitchell

AU - Wolfe, Walter

AU - Lucke, John C.

AU - Mediratta, Sundeep

AU - Booth, David

AU - Barbiere, Charles

AU - Lewis, Daniel

PY - 2001/7/16

Y1 - 2001/7/16

N2 - BACKGROUND: Percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG) are being applied to high-risk populations, but previous randomized trials comparing revascularization methods have excluded a number of important high-risk groups. OBJECTIVES: This five-year, multicenter, randomized clinical trial was designed to compare long-term survival among patients with medically refractory myocardial ischemia and a high risk of adverse outcomes assigned to either a CABG or a PCI strategy, which could include stents. METHODS: Patients from 16 Veterans Affairs Medical Centers were screened to identify myocardial ischemia refractory to medical management and the presence of one or more risk factors for adverse outcome with CABG, including prior open-heart surgery, age >70 years, left ventricular ejection fraction <0.35, myocardial infarction within seven days or intraaortic balloon pump required. Clinically eligible patients (n = 2,431) underwent coronary angiography; 781 were angiographically acceptable; 454 (58% of eligible) patients consented to random assignment between CABG and PCI. RESULTS: A total of 232 patients was randomized to CABG and 222 to PCI. The 30-day survivals for CABG and PCI were 95% and 97%, respectively. Survival rates for CABG and PCI were 90% versus 94% at six months and 79% versus 80% at 36 months (log-rank test, p = 0.46). CONCLUSIONS: Percutaneous coronary intervention is an alternative to CABG for patients with medically refractory myocardial ischemia and a high risk of adverse outcomes with CABG.

AB - BACKGROUND: Percutaneous coronary intervention (PCI) and coronary artery bypass graft surgery (CABG) are being applied to high-risk populations, but previous randomized trials comparing revascularization methods have excluded a number of important high-risk groups. OBJECTIVES: This five-year, multicenter, randomized clinical trial was designed to compare long-term survival among patients with medically refractory myocardial ischemia and a high risk of adverse outcomes assigned to either a CABG or a PCI strategy, which could include stents. METHODS: Patients from 16 Veterans Affairs Medical Centers were screened to identify myocardial ischemia refractory to medical management and the presence of one or more risk factors for adverse outcome with CABG, including prior open-heart surgery, age >70 years, left ventricular ejection fraction <0.35, myocardial infarction within seven days or intraaortic balloon pump required. Clinically eligible patients (n = 2,431) underwent coronary angiography; 781 were angiographically acceptable; 454 (58% of eligible) patients consented to random assignment between CABG and PCI. RESULTS: A total of 232 patients was randomized to CABG and 222 to PCI. The 30-day survivals for CABG and PCI were 95% and 97%, respectively. Survival rates for CABG and PCI were 90% versus 94% at six months and 79% versus 80% at 36 months (log-rank test, p = 0.46). CONCLUSIONS: Percutaneous coronary intervention is an alternative to CABG for patients with medically refractory myocardial ischemia and a high risk of adverse outcomes with CABG.

UR - http://www.scopus.com/inward/record.url?scp=0034964416&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0034964416&partnerID=8YFLogxK

U2 - 10.1016/S0735-1097(01)01366-3

DO - 10.1016/S0735-1097(01)01366-3

M3 - Article

C2 - 11451264

AN - SCOPUS:0034964416

VL - 38

SP - 143

EP - 149

JO - Journal of the American College of Cardiology

JF - Journal of the American College of Cardiology

SN - 0735-1097

IS - 1

ER -