25. The CARP Trial

"I don't believe you. There must be an advantage to prophylactic CABG in patients scheduled for elective surgery! 3.2% + 1.5% must be less than 3%." Well, there is a trial of that exact question. The CARP trial (Coronary Artery Revascularization Prophylaxis Trial) was a Multi-centered, randomized, prospective, controlled trial sponsored by the Department of Veterans Affairs which enrolled patients with significant coronary artery disease who were undergoing operations for peripheral arterial disease. They were randomized to myocardial revascularization (CABG) versus best medical care. They tested the hypothesis that 3.2% + 1.5% < 3%. They definitively proved that the risk of two operations is greater than one. Prophylactic therapies must have lower risk than the original problem. Do not use prophylactic therapies that have a greater risk than the original problem.

The CARP Trial

	Coronary Artery Revascularization Prophylaxis Trial.
	Multi-centered, randomized, prospective, controlled trial sponsored by the Department of Veterans Affairs
	.Patients with significant CAD who are undergoing operations for peripheral arterial disease are randomized to myocardial revascularization versus best medical care
	Can 3.2 + 1.5 < 3.0 ?
	NO.