The Emory Angioplasty vs Surgery Trial (EAST) was the outgrowth of the vision of Andreas Grüntzig, expressed as early as 1983, to compare the two revascularization methods in patients with multivessel disease. With sponsorship of the National Heart, Lung and Blood Institute, 392 patients were randomized and followed with 1- and 3-year angiograms and perfusion nuclear scans, and 450 patients were followed in a parallel registry starting in 1987. Now with complete 8-year follow-up, there is no significant survival difference. Revascularization was more complete in the surgery patients, and repeat procedures more common in the PTCA group. Excess procedures in follow-up were concentrated in the first years and the extended 5-year follow-up showed relatively equal use of repeat procedures. The superiority of surgery in diabetic patients seen in the BARI trial was also supported by the EAST findings.
Copyright 1999 Harcourt Publishers Ltd.