SURVIVAL OF MEN TREATED FOR CHRONIC STABLE ANGINA-PECTORIS - COOPERATIVE RANDOMIZED STUDY

  • 1 January 1978
    • journal article
    • research article
    • Vol. 75  (1) , 1-16
Abstract
During 1972-1974, 686 men aged 27-67 yr, with stable angina, resting or exercise ECG abnormalities, graftable arteries and abnormal left ventricular function (80%) were randomly assigned to surgery (332) or medical (354) treatment. There was no significant difference in clinical, angiographic and ventriculographic characteristics. The over-all operative mortality rate (30 days) was 5.8%, 5% in the 95% who had saphenous vein aorta-coronary bypass alone. Of the 79% recatheterized at 1 yr, 89% had at least one patent graft. Longevity for patients with 1, 2 and 3 vessel disease who were treated surgically was comparable to that previously described, but did not differ from that of the medically treated groups. Survival in the over-all surgical group was 86% at 4 yr as compared to 83% in the medical group, which in these operative candidates is better than usually cited. This difference was eliminated when the 90 patients (13%) with left main disease, whose longevity was significantly improved (P = 0.005) by the operation, were excluded. Despite this exclusion, a slight trend in favor of surgery was still discernible in the largest subgroup, those having triple vessel disease with an abnormal left ventricle.