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Updated: Jan 29, 2026
01:29
The Number e as a Limit
Published on: January 12, 2026
85
Long-term clinical outcome in the Bypass Angioplasty Revascularization Investigation Registry: comparison with the
1Department of Epidemiology, University of Pittsburgh, Pittsburgh, PA, USA. frederick.feit@nyu.med.edu
Circulation
|June 22, 2000
Summary
Physician-guided percutaneous transluminal coronary angioplasty (PTCA) versus coronary artery bypass graft surgery (CABG) in the BARI registry showed similar long-term survival. This held true for overall patients and treated diabetics, demonstrating physician choice did not compromise outcomes.
Area of Science:
- Cardiovascular Medicine
- Interventional Cardiology
- Clinical Trials
Background:
- The Bypass Angioplasty Revascularization Investigation (BARI) enrolled 4039 patients with multivessel coronary artery disease.
- 1829 patients consented to randomization, while 2010 followed a physician-guided registry approach.
- This design allows comparison of random assignment versus physician choice for percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass graft surgery (CABG).
Purpose of the Study:
- To evaluate the long-term outcomes of physician-guided treatment selection versus random assignment for PTCA and CABG.
- To compare the effectiveness of PTCA and CABG in patients with multivessel coronary artery disease within a registry setting.
- To assess the impact of treatment choice on survival, particularly in diabetic patients.
Main Methods:
- Comparison of baseline characteristics and 7-year outcomes between PTCA and CABG in the BARI registry and randomized trial.
- Statistical adjustments were applied to account for differences in baseline patient characteristics.
- Analysis focused on overall mortality and subgroup analyses, including treated diabetics.
Main Results:
- In the registry, PTCA was selected more often than CABG (1189 vs. 625).
- Seven-year mortality was similar for PTCA (13.9%) and CABG (14.2%) in the registry (P=0.66), even after adjustment.
- Treated diabetics in the registry had equally high mortality (26%) with either PTCA or CABG; PTCA mortality was higher in the randomized trial than the registry (19.1% vs. 13.9%, P<0.01).
Conclusions:
- BARI physicians successfully selected PTCA over CABG for 65% of registry patients undergoing revascularization.
- Physician-guided treatment selection did not compromise long-term survival in the overall population or in treated diabetics.
- The study supports the feasibility of physician-guided revascularization strategies without negatively impacting long-term patient survival.
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