ARGUMENTATION - BETTER

AGGREGATE REMOVED- 10

Source: NEJM - carenini@cs.pitt.edu

SPECIFIC QUESTION: What method of revascularization is better? CABG or PTCA? and does it depend on any patient characteristics?

PAPER CONCLUSIONS: As compared with CABG, an initial strategy of PTCA did not significantly compromise five-year survival in patients with multivessel disease, although subsequent revascularization was required more often with this strategy. For treated diabetics, five-year survival was significantly better after CABG than after PTCA. (N Engl J Med 1996;335:217-25.)

COMMENTS:

• The goal of the experiment was to compare two alternative methods of revascularization, CABG and PTCA. Five-year clinical outcome was compared for different (non mutually exclusive) aggregates of the patients. The difference was significant only for patients with treated history of diabetes.
• The second chart shows the comparison excluding patients with treated history of diabetes. The general idea is to find out whether the positive effect of CABG for patients with treated history of diabetes was contrasting possible positive effects of PTCA for other patient aggregates (remember that the aggregates are not mutually exclusive).