The final 10-year follow-up results from the BARI randomized trial

J Am Coll Cardiol. 2007 Apr 17;49(15):1600-1606. doi: 10.1016/j.jacc.2006.11.048. Epub 2007 Apr 2.


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.

Publication types

  • Comparative Study
  • Randomized Controlled Trial
  • Research Support, N.I.H., Extramural

MeSH terms

  • Aged
  • Aged, 80 and over
  • Angioplasty, Balloon, Coronary / adverse effects
  • Angioplasty, Balloon, Coronary / methods*
  • Coronary Angiography
  • Coronary Artery Bypass / adverse effects
  • Coronary Artery Bypass / methods*
  • Coronary Disease / diagnostic imaging
  • Coronary Disease / mortality*
  • Coronary Disease / therapy*
  • Evaluation Studies as Topic
  • Female
  • Follow-Up Studies
  • Humans
  • Male
  • Middle Aged
  • Probability
  • Proportional Hazards Models
  • Risk Assessment
  • Severity of Illness Index
  • Survival Rate
  • Time Factors
  • Treatment Outcome
  • Vascular Patency / physiology