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This Article Figures Only Full Text Full Text (PDF) View Online Only Appendix All Versions of this Article: j.jacc.2004.12.081v1 46/4/582    most recent Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Related articles in JACC Similar articles in this journal Similar articles in ISI Web of Science Similar articles in PubMed Alert me to new issues of the journal Download to citation manager Citing Articles Citing Articles via HighWire Citing Articles via ISI Web of Science (24) Citing Articles via Google Scholar Google Scholar Articles by Rodriguez, A. E. Search for Related Content PubMed PubMed Citation Articles by Rodriguez, A. E.

CLINICAL RESEARCH: CLINICAL TRIALS

Five-Year Follow-Up of the Argentine Randomized Trial of Coronary Angioplasty With Stenting Versus Coronary Bypass Surgery in Patients With Multiple Vessel Disease (ERACI II)

Alfredo E. Rodriguez, MD, PhD, FACC^_*, Julio Baldi, MD, PhD^_*, Carlos Fernández Pereira, MD^_*, Jose Navia, MD^_*, Máximo Rodriguez Alemparte, MD^_*, Alejandro Delacasa, MD, Federico Vigo, MD^_*, Daniel Vogel, MD^_*, William O'Neill, MD, FACC, Igor F. Palacios, MD, FACC,^,_* on behalf of the ERACI II Investigators

^_* Otamendi Hospital, Buenos Aires, Argentina
Sanatorio Belgrano, Mar del Plata, Argentina
William Beaumont Hospital, Royal Oak, Michigan
Massachusetts General Hospital, Boston, Massachusetts

Manuscript received October 11, 2004; revised manuscript received December 13, 2004, accepted December 20, 2004.

^_* Reprint requests and correspondence: Dr. Igor F. Palacios, Cardiac Catheterization Laboratory, Interventional Cardiology, Massachusetts General Hospital, Boston, Massachusetts 02114 (Email: ipalacios{at}partners.org).

OBJECTIVES: The purpose of the present study is to report the five-year follow-up results of the ERACI II trial.

BACKGROUND: Immediate and one-year follow-up results of the ERACI II study showed a prognosis advantage of percutaneous coronary intervention (PCI) with stents over coronary artery bypass grafting (CABG).

METHODS: A total of 450 patients were randomly assigned to undergo either PCI (n = 225); or CABG (n = 225). Only patients with multi-vessel disease were enrolled. Clinical follow-up during five years was obtained in 92% of the total population after hospital discharge. The primary end point of the study was to compare freedom from major adverse cardiovascular events (MACE) at 30 days, 1 year, 3 years, and 5 years of follow-up.

RESULTS: At five years of follow-up, patients initially treated with PCI had similar survival and freedom from non-fatal acute myocardial infarction than those initially treated with CABG (92.8% vs. 88.4% and 97.3% vs. 94% respectively, p = 0.16). Freedom from repeat revascularization procedures (PCI/CABG) was significantly lower with PCI compared with CABG (71.5% vs. 92.4%, p = 0.0002). Freedom from MACE was also significantly lower with PCI compared with CABG (65.3% vs. 76.4%; p = 0.013). At five years similar numbers of patients randomized to each revascularization procedure were asymptomatic or with class I angina.

CONCLUSIONS: At five years of follow-up, in the ERACI II study, there were no survival benefits from any revascularization procedure; however patients initially treated with CABG had better freedom from repeat revascularization procedures and from MACE.

Abbreviations and Acronyms   AMI = acute myocardial infarction   ARTS = Artery Revascularization Therapies Study   CABG = coronary artery bypass grafting   CAD = coronary artery disease   ERACI II = Argentine Randomized Study: Coronary Angioplasty with Stenting Versus Coronary Bypass Surgery in Multi-Vessel Disease   LAD = left anterior descending   LIMA = left internal mammary artery graft   MACE = major adverse cardiovascular events   PCI = percutaneous coronary intervention   PTCA = percutaneous transluminal coronary angioplasty

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