Tags

Type your tag names separated by a space and hit enter

Comparison of bypass surgery and stenting for the treatment of multivessel disease: results from the ARTS trial in Israel.
Isr Med Assoc J. 2003 Aug; 5(8):539-42.IM

Abstract

BACKGROUND

The Arterial Revascularization Therapies Study was a multicenter, randomized trial designed to compare percutaneous coronary intervention with stenting versus coronary artery bypass graft surgery in 1,205 patients with multivessel coronary artery disease. The most appropriate type of treatment for these patients is still a matter of considerable debate.

OBJECTIVES

To evaluate the clinical characteristics of patients enrolled in the ARTS trial in Israel in comparison to those worldwide, and to assess the 1 year outcome in these patients.

METHODS

Between April 1997 and June 1998, a total of 1,205 patients with multivessel coronary artery disease, who were considered to be equally treatable with both modalities, were randomized to either stenting (n = 600) or CABG (n = 605) at 67 centers around the world. In Israel, 53 patients at four participating medical centers were randomized to either PCI with stents (n = 27) or CABG (n = 26).

RESULTS

Clinical and angiographic characteristics were similar in the two groups, except for a significantly higher incidence of diabetic patients in Israel who were randomized to CABG, compared to those worldwide (35% vs. 16%, P = 0.01). Also, there were more patients with unstable angina in Israel (63 vs. 37%, P = 0.006). At 1 year follow-up, overall mortality and cerebrovascular accident rates were similar between the two groups and equivalent to results obtained around the world. There was a significantly higher incidence of myocardial infarction rates in patients randomized to stenting in Israel compared to patients worldwide (7.4 vs. 5.3%, P = 0.01) or to patients randomized to CABG in Israel (7.4 vs. 0%, P = 0.006). Similar to the overall ARTS results, there was a higher incidence of repeat revascularization procedures in patients assigned to the PCI with stenting arm (22.2 vs. 3.8%, P = 0.004) compared to those randomized to CABG, respectively.

CONCLUSIONS

The results of this analysis of the Israeli ARTS population indicate that coronary stenting and bypass surgery yield similar findings with regard to mortality and stroke and are comparable to those obtained in the whole study group. Likewise, coronary stenting was associated with an increased incidence of repeat revascularization procedures as compared to CABG. However, patients in Israel randomized to stenting had a higher rate of myocardial infarction as compared to the overall results and to patients who underwent CABG in Israel. The present analysis provides important data for the safety and efficacy of either stenting or bypass surgery in treating patients with multivessel disease in Israel.

Authors+Show Affiliations

Division of Invasive Cardiology, Dept. of Cardiology, Rambam Medical Center, Haifa 31096, Israel. gruberg67@hotmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Clinical Trial
Comparative Study
Journal Article
Multicenter Study
Randomized Controlled Trial

Language

eng

PubMed ID

12929288

Citation

Gruberg, Luis, et al. "Comparison of Bypass Surgery and Stenting for the Treatment of Multivessel Disease: Results From the ARTS Trial in Israel." The Israel Medical Association Journal : IMAJ, vol. 5, no. 8, 2003, pp. 539-42.
Gruberg L, Milo S, Ben Tzvi M, et al. Comparison of bypass surgery and stenting for the treatment of multivessel disease: results from the ARTS trial in Israel. Isr Med Assoc J. 2003;5(8):539-42.
Gruberg, L., Milo, S., Ben Tzvi, M., Lotan, C., Merin, G., Braun, S., Mohr, R., Tzivoni, D., Bitran, D., & Beyar, R. (2003). Comparison of bypass surgery and stenting for the treatment of multivessel disease: results from the ARTS trial in Israel. The Israel Medical Association Journal : IMAJ, 5(8), 539-42.
Gruberg L, et al. Comparison of Bypass Surgery and Stenting for the Treatment of Multivessel Disease: Results From the ARTS Trial in Israel. Isr Med Assoc J. 2003;5(8):539-42. PubMed PMID: 12929288.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Comparison of bypass surgery and stenting for the treatment of multivessel disease: results from the ARTS trial in Israel. AU - Gruberg,Luis, AU - Milo,Simcha, AU - Ben Tzvi,Margalit, AU - Lotan,Chaim, AU - Merin,Gideon, AU - Braun,Shimon, AU - Mohr,Rephael, AU - Tzivoni,Dan, AU - Bitran,Dan, AU - Beyar,Rafael, AU - ,, PY - 2003/8/22/pubmed PY - 2003/9/10/medline PY - 2003/8/22/entrez SP - 539 EP - 42 JF - The Israel Medical Association journal : IMAJ JO - Isr. Med. Assoc. J. VL - 5 IS - 8 N2 - BACKGROUND: The Arterial Revascularization Therapies Study was a multicenter, randomized trial designed to compare percutaneous coronary intervention with stenting versus coronary artery bypass graft surgery in 1,205 patients with multivessel coronary artery disease. The most appropriate type of treatment for these patients is still a matter of considerable debate. OBJECTIVES: To evaluate the clinical characteristics of patients enrolled in the ARTS trial in Israel in comparison to those worldwide, and to assess the 1 year outcome in these patients. METHODS: Between April 1997 and June 1998, a total of 1,205 patients with multivessel coronary artery disease, who were considered to be equally treatable with both modalities, were randomized to either stenting (n = 600) or CABG (n = 605) at 67 centers around the world. In Israel, 53 patients at four participating medical centers were randomized to either PCI with stents (n = 27) or CABG (n = 26). RESULTS: Clinical and angiographic characteristics were similar in the two groups, except for a significantly higher incidence of diabetic patients in Israel who were randomized to CABG, compared to those worldwide (35% vs. 16%, P = 0.01). Also, there were more patients with unstable angina in Israel (63 vs. 37%, P = 0.006). At 1 year follow-up, overall mortality and cerebrovascular accident rates were similar between the two groups and equivalent to results obtained around the world. There was a significantly higher incidence of myocardial infarction rates in patients randomized to stenting in Israel compared to patients worldwide (7.4 vs. 5.3%, P = 0.01) or to patients randomized to CABG in Israel (7.4 vs. 0%, P = 0.006). Similar to the overall ARTS results, there was a higher incidence of repeat revascularization procedures in patients assigned to the PCI with stenting arm (22.2 vs. 3.8%, P = 0.004) compared to those randomized to CABG, respectively. CONCLUSIONS: The results of this analysis of the Israeli ARTS population indicate that coronary stenting and bypass surgery yield similar findings with regard to mortality and stroke and are comparable to those obtained in the whole study group. Likewise, coronary stenting was associated with an increased incidence of repeat revascularization procedures as compared to CABG. However, patients in Israel randomized to stenting had a higher rate of myocardial infarction as compared to the overall results and to patients who underwent CABG in Israel. The present analysis provides important data for the safety and efficacy of either stenting or bypass surgery in treating patients with multivessel disease in Israel. SN - 1565-1088 UR - https://www.unboundmedicine.com/medline/citation/12929288/Comparison_of_bypass_surgery_and_stenting_for_the_treatment_of_multivessel_disease:_results_from_the_ARTS_trial_in_Israel_ L2 - http://www.ima.org.il/IMAJ/ViewArticle.aspx?year=2003&month=08&page=539 DB - PRIME DP - Unbound Medicine ER -