title: Argentine Randomized Study: Coronary Angioplasty with Stenting versus Coronary Bypass Surgery in patients with Multiple-Vessel Disease (ERACI II): 30-day and one-year follow-up results. ERACI II Investigators.
abstract: OBJECTIVE
  The purpose of this study was to compare percutaneous transluminal coronary revascularization (PTCR) employing stent implantation to conventional coronary artery bypass graft surgery (CABG) in symptomatic patients with multivessel coronary artery disease.
  
  
  BACKGROUND
  Previous randomized studies comparing balloon angioplasty versus CABG have demonstrated equivalent safety results. However, CABG was associated with significantly fewer repeat revascularization procedures.
  
  
  METHODS
  A total of 2,759 patients with coronary artery disease were screened at seven clinical sites, and 450 patients were randomly assigned to undergo either PTCR (225 patients) or CABG (225 patients). Only patients with multivessel disease and indication for revascularization were enrolled.
  
  
  RESULTS
  Both groups had similar clinical demographics: unstable angina in 92%; 38% were older than 65 years, and 23% had a history of peripheral vascular disease. During the first 30 days, PTCR patients had lower major adverse events (death, myocardial infarction, repeat revascularization procedures and stroke) compared with CABG patients (3.6% vs. 12.3%, p = 0.002). Death occurred in 0.9% of PTCR patients versus 5.7% in CABG patients, p < 0.013, and Q myocardial infarction (MI) occurred in 0.9% PTCR versus 5.7% of CABG patients, p < 0.013. At follow-up (mean 18.5 +/- 6.4 months), survival was 96.9% in PTCR versus 92.5% in CABG, p < 0.017. Freedom from MI was also better in PTCR compared to CABG patients (97.7% vs. 93.4%, p < 0.017). Requirements for new revascularization procedures were higher in PTCR than in CABG patients (16.8% vs. 4.8%, p < 0.002).
  
  
  CONCLUSIONS
  In this selected high-risk group of patients with multivessel disease, PTCR with stent implantation showed better survival and freedom from MI than did conventional surgery. Repeat revascularization procedures were higher in the PTCR group.
authors.affiliation: Otamendi Hospital, Buenos Aires, Argentina.
authors.forename: A
authors.initials: A
authors.lastname: Rodriguez
authors.forename: V
authors.initials: V
authors.lastname: Bernardi
authors.forename: J
authors.initials: J
authors.lastname: Navia
authors.forename: J
authors.initials: J
authors.lastname: Baldi
authors.forename: L
authors.initials: L
authors.lastname: Grinfeld
authors.forename: J
authors.initials: J
authors.lastname: Martinez
authors.forename: D
authors.initials: D
authors.lastname: Vogel
authors.forename: R
authors.initials: R
authors.lastname: Grinfeld
authors.forename: A
authors.initials: A
authors.lastname: Delacasa
authors.forename: M
authors.initials: M
authors.lastname: Garrido
authors.forename: R
authors.initials: R
authors.lastname: Oliveri
authors.forename: E
authors.initials: E
authors.lastname: Mele
authors.forename: I
authors.initials: I
authors.lastname: Palacios
authors.forename: W
authors.initials: W
authors.lastname: O'Neill
mesh_terms: D000368:Aged; D015906:Angioplasty, Balloon, Coronary; D001118:Argentina; D001026:Coronary Artery Bypass; D003327:Coronary Disease / Q000401:mortality / Q000628:therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D008297:Male; D008875:Middle Aged; D015607:Stents; D015996:Survival Rate