16. Risk of CABG vs PCI vs Medical Therapy at One Year

Maybe we should get the cardiac risk stratification so that we can identify the patient at risk for coronary disease and they can get a benefit from a CABG. Let's look at the risk of CABG versus PCI versus Medical therapy at one year. Hueb et. al. J AmColl Cardiol. 2004 May 19;43(10):1743-51 found that in the medicine, angioplasty, or surgery study (MASS-II): a randomized, controlled clinical trial of three therapeutic strategies for multivessel coronary artery disease: J AmColl Cardiol. 2004 May 19;43(10):1743-51 found that patients who were randomized to medical therapy had a 1.5% mortality as compared to 4.0% for CABG and 4.4% for PCI. So, at one year, it is better to receive medical therapy than PCI or CABG. Cheaper too!

Hueb et. al. The medicine, angioplasty, or surgery study (MASS-II): a randomized, controlled clinical trial of three therapeutic strategies for multivessel coronary artery disease: one-year results. J AmColl Cardiol. 2004 May 19;43(10):1743-51

	Medical therapy was superior to PCI.
	CABG was superior to MT for eliminating anginal symptoms.
	All three therapeutic regimens yielded relatively low rates of cardiac-related deaths.