CLINICAL AND OPERATIVE CHARACTERISTICS OF PATIENTS RANDOMIZED TO CORONARY-ARTERY BYPASS-SURGERY IN THE BYPASS ANGIOPLASTY REVASCULARIZATIONINVESTIGATION (BARI)
Hv. Schaff et al., CLINICAL AND OPERATIVE CHARACTERISTICS OF PATIENTS RANDOMIZED TO CORONARY-ARTERY BYPASS-SURGERY IN THE BYPASS ANGIOPLASTY REVASCULARIZATIONINVESTIGATION (BARI), The American journal of cardiology, 75(9), 1995, pp. 18-26
The surgical cohort of the Bypass Angioplasty Revascularization Invest
igation (BARI) is the largest group of patients with multivessel coron
ary artery disease randomly assigned to surgical treatment. This repor
t presents baseline and operative characteristics of the cohort and de
scribes some aspects of the variability in surgical practice among the
14 primary clinical centers and 4 so-investigational sites participat
ing in BARI. Preoperative clinical and angiographic data and intraoper
ative variables were reviewed in 892 patients who were randomly assign
ed to coronary artery bypass grafting (CABG) and underwent operation.
Associations between patient/lesion variables and operative characteri
stics are described. Of patients assigned to CABG, 87% underwent an op
eration within 2 weeks of randomization, as recommended in the protoco
l. Mean age of the 892 patients was 61 years, and mean age of the 235
women was greater than that of men (64 years vs 60 years); 64% of the
surgical patients were classified as having unstable angina during the
6 weeks prior to randomization. Coronary angiography demonstrated 3-v
essel disease (50% diameter narrowing by caliper measurement) in 41% o
f patients, and disease of the left anterior descending coronary arter
y was present in 87% of patients. A mean of 3.1 coronary arteries per
patient were bypassed, and 82% of patients received 1 (70%) or 2 (12%)
internal thoracic artery grafts. Prevalence of infernal thoracic graf
ts was lower in elderly patients (74% of patients greater than or equa
l to 70 years), in women (72% vs 85% in men; p < 0.01), and in black p
articipants (65%). There was significant center-to-center variation in
duration of cardiopulmonary bypass and aortic cross-clamping, methods
of intraoperative myocardial protection, and in graft usage. Surgical
patients in BARI differ considerably from patients entered into previ
ous randomized trials in that the operative methods and graft usage re
flect contemporary practice of coronary artery surgery, although signi
ficant variations among institutions were observed.