Comparison of effects of medical and surgical therapy on survival in severe angina pectoris and two-vessel coronary artery disease with and without left ventricular dysfunction: A coronary artery surgery study registry study

Michael B. Mock, Lloyd D. Fisher, David Holmes, Bernard J. Gersh, Hartzell V Schaff, Mary McConney, William J. Rogers, George C. Kaiser, Thomas J. Ryan, William O. Myers, Thomas Killip, in the Coronary Artery Surgery Study Participants in the Coronary Artery Surgery Study

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43 Scopus citations

Abstract

This nonrandomized study compared the results of early coronary artery bypass grafting to those of initial medical therapy in a group of 2,023 patients with severe angina pectoris and 2 major epicardial coronary arteries having ≥70% diameter luminal narrowing. Medical therapy was selected for 706 patients, and 1,317 patients were treated by coronary artery bypass grafting. The 6-year survival rate was 76% for patiente treated medically and 89% for patients treated surgically (p < 0.0001). Cox multivariate analysis showed that surgical treatment was a beneficial independent predictor of survival (p < 0.001). For patients with 2-vessel coronary artery disease who had Canadian Heart Association class III and IV angina at presentation, surgical therapy provided a survival advantage for patients with impaired left ventricular function and proximal narrowing of 1 or more coronary arteries.

Original languageEnglish (US)
Pages (from-to)1198-1203
Number of pages6
JournalThe American Journal of Cardiology
Volume61
Issue number15
DOIs
StatePublished - Jun 1 1988

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

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    Mock, M. B., Fisher, L. D., Holmes, D., Gersh, B. J., Schaff, H. V., McConney, M., Rogers, W. J., Kaiser, G. C., Ryan, T. J., Myers, W. O., Killip, T., & Participants in the Coronary Artery Surgery Study, I. T. C. A. S. S. (1988). Comparison of effects of medical and surgical therapy on survival in severe angina pectoris and two-vessel coronary artery disease with and without left ventricular dysfunction: A coronary artery surgery study registry study. The American Journal of Cardiology, 61(15), 1198-1203. https://doi.org/10.1016/0002-9149(88)91154-X