Principal Findings:

After 2.5 years of follow-up:
There have been 34 deaths (18 CABG, 16 PTCA). The pre-defined combined primary event of death or definite myocardial infarction shows no evidence of a treatment difference (43 CABG, 50 PTCA; relative risk 0.88 [95% confidence interval 0.59-1.29]).

4% of PTCA patients required emergency CABG before discharge and a further 15% had CABG during follow-up.

Within 2 years of randomization 38% and 11% of the PTCA and CABG groups, respectively, required revascularization procedure(s) or had a primary event (p < 0.001) and repeat coronary arteriography during follow-up was four times more common in PTCA than in CABG patients (31% vs. 7%, p < 0.001).

The prevalence of angina during follow-up was higher in the PTCA group (e.g., 32% vs. 11% at 6 months) but this difference became less marked after 2 years (31% vs. 22%). Anti-anginal drugs were prescribed more frequently for PTCA patients. At 1 month CABG patients were less physically active, with greater coronary related unemployment and lower mean exercise times than the PTCA patients. Thereafter employment status, breathlessness, and physical activity improved, with no significant differences between the two treatment groups.

At 1 year mean exercise times had increased by 3 min for both groups.

Resting ejection fractions were studied in 47% of patients. At both 1 month and 6 months after randomization, there was no evidence of change in either treatment group. For instance, at 6 months the mean changes were -0.1% for the CABG group and +0.3% for the PTCA group.

The initial average cost of treating a patient randomized to PTCA was about 52% of that of CABG, but after 2 years this increased to about 80% because of the greater need for subsequent interventions.

After 3 years of follow-up:
Both PTCA and CABG produced marked improvement in all quality-of-life dimensions (energy, pain, emotional reactions, sleep, social isolation, and mobility) and aspects of daily living.

Patients with angina at two years had more quality-of-life impairment than angina-free patients, whose perceived health was similar to population norms. This reflects the close link at baseline between angina grade and quality of life. The slightly greater impairment of quality of life in PTCA compared with CABG patients is a result of their significantly higher chances of having angina, especially after 6 months.

Employment status was investigated mainly for men <60 years old. PTCA patients returned to work sooner (40% at 2 months compared with 10% of CABG patients), but the latter caught up by 5 months. After 2 years, 22% and 26% of CABG and PTCA patients, respectively, were not working for cardiac reasons. Patients with angina at 2 years were much more likely to be unemployed than those without.