FIRST-YEAR RESULTS OF CABRI (CORONARY ANGIOPLASTY VERSUS BYPASS REVASCULARIZATION INVESTIGATION)

The Coronary Angioplasty versus Bypass Revascularisation Investigation (CABRI) is a multinational, multicentre randomized trial comparing th e strategies of revascularisation by CABG (coronary artery bypass graf ting) and PTCA (percutaneous transluminal coronary angioplasty) in pat ients with symptomatic multivessel coronary disease. 1054 patients (82 0 men and 234 women) were recruited from 26 European cardiac centres. The average age was 60 years and 62% presented with angina of class 3 or greater. 513 patients were randomisd to CABG and 541 to PTCA, and 9 3% and 96%, respectively, of those randomised underwent the allocated procedure. This first report presents data analysed by intention to tr eat and documents all deaths, major cardiac events, and the symptom st atus of the patients 1 year after ramdomisation. After 1 year of follo w-up, 14 (2 . 7%) of those randomised to CABG and 21 (3 . 9%) of those randomised to PTCA had died. The PTCA group's relative rish (RR) of d eath was 1 . 42 (95% CI 0 . 73-2 . 76). Patients randomised to PTCA re quired significantly more reinterventions; only 66 . 4% reached 1 year with a single revascularisaton procedure compared with 93 . 5% of pat ients randomised to CABG (RR=5 . 23 [3 . 90-7 . 03], p<0 . 001). The p atients in the PTCA group took significantly more medication at 1 year (RR=1 . 30 [1 . 18-1 . 43], p<0 . 001). They were also more likely to have clinically significant angina (RR=1 . 54 [1 . 09-2 . 16], p=0 . 012); this association was present in both sexes but was significant o nly in females. CABRI is the largest trial of CABG versus PTCA to be r eported so far. Its findings are consistent with previous studies, and add to the weight of information that dinicians need to discuss with patients when options for the management of severe angina are under co nsideration.