The BARI study, was designed to compare the benefits and risks of PTCA and CABG through random assignment of revascularization strategy with systematic follow-up over a period of five or more years while evaluating the long-term outcome of these patients. Investigators randomized a total of 1829 patients (129 at Duke) and have followed these patients with telephone contact, clinical evaluations, exercise treadmill tests, lipid panels and in-depth socioeconomic surveys. In addition, 310 randomized patients at seven participating sites underwent coronary angiography at 10-14 months following the baseline angiogram and again at five years. We have recently finished the five year clinic evaluations for the final group of patients who were enrolled in the BARI study. At the Duke Medical Center site this evaluation was performed on the GCRC and included exercise treadmill, Multigated Acquisition (MUGA), blood work, cardiac catheterization and an overnight admission on the GCRC. The initial endpoint data was presented at the AHA meeting in Nov. 1995 that examined 67% of the patients who had completed five year follow up. A paper describing the clinical endpoints was published in the New England Journal of Medicine in July 1996. The paper's conclusions were: """"""""As compared with CABG, an initial strategy of PTCA, did not significantly compromise five-year survival in patients with multivessel disease, although subsequent revascularization was required more often with this strategy. For treated diabetics, five-year survival was significantly better after CABG than after PTCA. Final analysis of the complete data set will further examine this finding during the next year of data clean up. Future plans are to continue telephone follow-up of the participating subjects until the end of 1997. A new protocol has been submitted to the NIH to allow us to continue follow-up on all BARI patients for ten years. A final ten year clinical visit for all randomized patients is being considered, using the GCRC.
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