Diabetics With Multivessel Disease Should Undergo CABG Surgery

(Washington, DC) - Ten-year results from the Bypass Angioplasty Revascularization Investigation (BARI) trial show no significant long-term advantage of an initial strategy of percutaneous transluminal coronary balloon angioplasty (PTCA) compared with coronary artery bypass grafting (CABG) [1]. The late results from the study come at a time when cardiologists are reexamining their dependence on percutaneous revascularization strategies, particularly in the wake of the COURAGE trial, which found no benefit in terms of death or MI of PCI over medical therapy, albeit in lower-risk patients than those enrolled in BARI.
BARI, however, was launched in the prestent era. "Although some might argue that these procedural refinements make the results of the BARI trial obsolete, we believe that our observations with respect to death and MI remain applicable to contemporary practice," the authors, led by Dr Maria Mori Brooks (University of Pittsburgh, Pennsylvania), write in the April 10, 2007 issue of the Journal of the American College of Cardiology. They point out that bare-metal stents and drug-eluting stents have not demonstrated a significant mortality or MI advantage over plain old balloon angioplasty.
http://www.medscape.com/viewarticle/554892?sssdmh=dm1.261850&src=nldne