Association between new electrocardiographic abnormalities after coronary revascularization and five-year cardiac mortality in BARI randomized and registry patients

There are few data comparing the relative frequency of new electrocardiagra phic (ECG) abnormalities after coronary artery bypass grafting (CABG) compa red with percutaneous transluminal coronary angioplasty (PTCA) and their as sociation with long-term cardiac mortality. The study population consisted of 3,373 patients who were either randomized or eligible to be randomized t o CABG or PTCA in the BARI trial. The frequency of new postprocedural ECG a bnormalities was significantly greater after a CABG procedure than after PT CA. The incidence of new postprocedural major Q waves, ST-segment elevation , and T-wave abnormalities were significantly more frequent after CABG. Aft er PTCA in = 1,869), the 5-year cardiac mortality rates associated with the new development of major Q waves, ST-seg- ment elevation, ST-segment depre ssion, T-wave abnormalities, or no abnormality was 18.1%, 8.5%, 8.9%, 6.0%, and 5.4%, respectively. After CABG (n = 1,427), 5-year cardiac mortality r ates were 8.0%, 4.2%, 3.8%, 2.8%6 and 3.7%, respectively. The adjusted rela tive risk of 5-year cardiac mortality for new Q-wave abnormalities was 2.6 after CABG (p <0.04) and 4.6 after PTCA (p <0.01). Thus, patients who under go CABG have more postinitial procedural ECG abnormalities than patients wh o undergo PTCA. Cardiac mortality is significantly increased by the new dev elopment of postprocedural Minnesota code Q-wave abnormalities regardless o f whether patients undergo CABG or PTCA. (C) 2000 by Excerpta Medico, Inc.