HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS		QUICK SEARCH:   [advanced] Author: Keyword(s): Year:  Vol:  Page:

This Article Alert me when this article is cited Alert me if a correction is posted Citation Map Services Email this article to a friend Similar articles in this journal Similar articles in PubMed Alert me to new issues of the journal Add to Personal Folders Download to citation manager Permission Requests Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Hochberg, M. S. Articles by Fisch, D. Search for Related Content PubMed PubMed Citation Articles by Hochberg, M. S. Articles by Fisch, D.

The Journal of Thoracic and Cardiovascular Surgery, Vol 97, 496-503, Copyright © 1989 by The American Association for Thoracic Surgery and The Western Thoracic Surgical Association

ARTICLES

Coronary angioplasty versus coronary bypass. Three-year follow-up of a matched series of 250 patients

MS Hochberg, I Gielchinsky, V Parsonnet, SM Hussain, E Mirsky and D Fisch
Department of Cardiovascular and Thoracic Surgery, Newark Beth Israel Medical Center, Newark, NJ 07112.

Two hundred fifty consecutive patients treated for one or two vessel coronary artery disease with either balloon angioplasty or surgical bypass were monitored for 3 years in a study designed to determine the comparative long-term effectiveness of each treatment. The 125 patients having angioplasty were matched with the 125 patients having bypass, so that both groups had a similar number of patients with single or double vessel disease. The two groups did not significantly differ in age, male:female ratio, New York Heart Association class, or risk factors. The ejection fraction was 54 +/- 11 in the angioplasty group and 49 +/- 12 mmHg in the surgical patients (p = 0.0031). Angioplasty was deemed initially successful in 88% (110/125), unsuccessful in 10% (12/125), and in 2% (3/125) the lesion could not be crossed. Emergency bypass was performed in 10% (12/125). Four of the 125 angioplasty patients (3%) died within 30 days. Coronary artery bypass grafting was successfully performed on the matched set of surgical patients with 99% (124/125) discharged well. There was one (1%, 1/125) surgical death. The average hospital stay per patient was 4.8 +/- 3.1 days for angioplasty and 12.1 +/- 4.2 days for bypass grafting (p = 0.0000). Three-year postprocedure follow-up was obtained on 96% (236) of the 245 patients discharged alive. A second angioplasty was required in 18%, and 11 angioplasty patients subsequently required surgical bypass. Overall, 19% (23/121) of the angioplasty patients ultimately required bypass. Four late deaths occurred in the angioplasty group, which brought the early and late mortality rates to 7% (8/121). There were two late surgical deaths, which brought the combined surgical mortality to 2.5% (3/120), p = 0.1263. Patient evaluation reveals that 63% (76/121) of the angioplasty group are alive and in New York Heart Association class I or II 3 years after one or two angioplasty procedures. This figure compares with 92% (110/120) of surgical patients alive and in the same two New York Heart Association classes (p = 0.0000).

This article has been cited by other articles:

				C.V Patil, E Nikolsky, M Boulos, E Grenadier, and R Beyar Multivessel coronary artery disease: current revascularization strategies Eur. Heart J., July 2, 2001; 22(14): 1183 - 1197. [PDF]

				M. Aristides, M. Gliksman, N. Rajan, and P. Davey Effectiveness and cost-effectiveness of single bolus treatment with abciximab (Reo Pro) in preventing restenosis following percutaneous transluminal coronary angioplasty in high risk patients Heart, January 1, 1998; 79(1): 12 - 17. [Abstract] [Full Text] [PDF]

				B. K. Podesser, S. Schwarzacher, W. Zwoelfer, T. M. Binder, E. Wolner, and R. Seitelberger COMPARISON OF PERIOPERATIVE MYOCARDIAL PROTECTION WITH NIFEDIPINE VERSUS NIFEDIPINE AND METOPROLOL IN PATIENTS UNDERGOING ELECTIVE CORONARY ARTERY BYPASS GRAFTING J. Thorac. Cardiovasc. Surg., November 1, 1995; 110(5): 1461 - 1469. [Abstract] [Full Text]

				R. G. Johnson, C. Sirois, J. F. Watkins, R. L. Thurer, F. W. Sellke, W. E. Cohn, R. E. Kuntz, and R. M. Weintraub CABG After Successful PTCA: A Case-Control Study Ann. Thorac. Surg., June 1, 1995; 59(6): 1391 - 1396. [Abstract] [Full Text]

				C. W. Hamm, J. Reimers, T. Ischinger, H.-J. Rupprecht, J. Berger, W. Bleifeld, and The German Angioplasty Bypass Surgery Investigatio A Randomized Study of Coronary Angioplasty Compared with Bypass Surgery in Patients with Symptomatic Multivessel Coronary Disease N. Engl. J. Med., October 20, 1994; 331(16): 1037 - 1043. [Abstract] [Full Text]

				R. Seitelberger, W. Hannes, M. Gleichauf, M. Keilich, M. Christoph, R. Fasol, Sponsored by, and E. Wolner Effects of diltiazem on perioperative ischemia, arrhythmias, and myocardial function in patients undergoing elective coronary bypass grafting J. Thorac. Cardiovasc. Surg., March 1, 1994; 107(3): 811 - 821. [Abstract] [Full Text]