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January 26, 1994

Once Again, CABG vs PTCA—Trial Results Today

JAMA. 1994;271(4):257. doi:10.1001/jama.1994.03510280013006

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ALTHOUGH TOTAL initial costs and charges are several thousand dollars higher for coronary artery bypass grafting (CABG) than for percutaneous transluminal coronary angioplasty (PTCA or balloon angioplasty) to treat occlusive heart disease, the overall results for patient health after both procedures have what one researcher called "an astonishing similarity" 1 to 5 years later.

Moreover, by 3 years after both procedures, the costs and charges tend to be alike, owing to the need for repeat angioplasties in about one third of all patients who undergo PTCA. These findings, of obvious interest in this era of fiscal medical reform, emerged from the reports of four ongoing trials presented at the annual meeting of the American Heart Association (AHA), held in Atlanta, Ga.

In 1991 (the latest year for which figures are available), there were 265 000 bypass operations performed in the United States and 303 000 balloon angioplasties, according to the

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