"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
Artery Revascularization Prophylaxis Trial.
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
3.2 + 1.5 < 3.0 ?
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