The Final 10-Year Follow-Up Results From the BARI Randomized Trial
Open accessAbstract
Objectives We sought to compare 10-year clinical outcomes in the BARI (Bypass Angioplasty Revascularization Investigation) trial patients who were randomly assigned to percutaneous transluminal coronary balloon angioplasty (PTCA) versus coronary artery bypass grafting (CABG).Background Angioplasty and bypass surgery have been compared in numerous studies, but long-term clinical outcomes are limited.Methods Symptomatic patients with multivessel coronary artery disease (n = 1,829) were randomly assigned to initial treatment with PTCA or CABG and followed up for an average of 10.4 years. Analyses were conducted on an intention-to-treat basis.Results The 10-year survival was 71.0% for PTCA and 73.5% for CABG (p = 0.18). At 10 years, the PTCA group had substantially higher subsequent revascularization rates than the CABG group (76.8% vs. 20.3%, p < 0.001), but angina rates for the 2 groups were similar. In the subgroup of patients with no treated diabetes, survival rates were nearly identical by randomization (PTCA 77.0% vs. CABG 77.3%, p = 0.59). In the subgroup with treated diabetes, the CABG assigned group had higher survival than the PTCA assigned group (PTCA 45.5% vs. CABG 57.8%, p = 0.025).Conclusions There was no significant long-term disadvantage regarding mortality or myocardial infarction associated with an initial strategy of PTCA compared with CABG. Among patients with treated diabetes, CABG conferred long-term survival benefit, whereas the 2 initial strategies were equivalent regarding survival for patients without diabetes.
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In BARI, patients with diabetes randomized to CABG had significantly better survival than those randomized to balloon angioplasty, with the difference continuing to grow through 10 years.
“In this trial, significantly improved survival was noted in the subgroup of patients with diabetes mellitus who were randomized to CABG, a difference that continued to accrue out to 10 years from study entry.279”
From Clinical management of stable coronary artery disease in patients with type 2 diabetes mellitus: a scientific statement from the American Heart Association (2020) · cites this paper as [279]
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- Authors
- The BARI Investigators
- Corresponding author
- The BARI Investigators
- Venue
- Journal of the American College of Cardiology
- Publisher
- Elsevier BV
- Published
- 2007-04
- Volume
- 49
- Issue
- 15
- Pages
- 1600-1606
- ISSN
- 0735-1097 (ISSN-L)
- OpenAlex
- W2341375528
- Cited by
- 447
- References
- 14
- Citations by year
- 2025: 8 · 2024: 4 · 2023: 12 · 2022: 11 · 2021: 9 · 2020: 18 · 2019: 20 · 2018: 17 · 2017: 26 · 2016: 28 · 2015: 36 · 2014: 38 · 2013: 39 · 2012: 36
- FWCI
- 33.87
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Licence
- Locations
- Journal of the American College of Cardiology (publishedVersion)
- PubMed (publishedVersion)
- Funders
- National Institutes of Health (5u01hl038532-11, 5u01hl038504-10, 5u01hl038556-10, 5u01hl038512-10, 5u01hl038642-11, 2u01hl038514-09, 5u01hl038509-10, 5u01hl038518-11, 5u01hl038529-11, 2u01hl038524-09, 2u01hl038493-09)
- National Heart, Lung, and Blood Institute (HL 38610, HL-38509, HL42145, HL-38529, HL38524-5, HL38514-6, HL38556, HL-38493, HL-38532, HL38642, HL-38504, HL-38518, HL 38512, U01HL038610)
- Topics
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
- Keywords
- percutaneous transluminal coronary angioplasty, coronary artery bypass grafting, multivessel coronary artery disease, long-term survival, revascularization, myocardial infarction, diabetes mellitus, coronary revascularization strategy
- MeSH terms
- Aged, Aged, 80 and over, Coronary Artery Bypass, Coronary Disease, Evaluation Studies as Topic, Female, Follow-Up Studies, Humans, Male, Middle Aged, Probability, Severity of Illness Index, Time Factors, Vascular Patency, Angioplasty, Balloon, Coronary, Survival Rate, Proportional Hazards Models, Treatment Outcome, Coronary Angiography, Risk Assessment
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