Circulation, Vol 59, 430-435, Copyright © 1979 by American Heart Association
KE Hammermeister, TA DeRouen and HT Dodge
Within the larger Seattle Heart Watch arteriography registry, surgically
treated patients non randomly selected for direct myocardial
revascularization were matched to medically treated patients such that each
of the 287 pairs was identical in seven variables (ejection fraction,
ventricular arrhythmia on resting electrocardiogram, age, heart murmur,
stenosis of left main coronary artery greater than or equal to 50%, number
of vessels with stenosis greater than or equal to 70%, and use of
diuretics) previously demonstrated to be independently predictive of
survival. Actuarial survival analyses based on cardiovascular deaths
(average follow-up 3.5 years) indicate improved survival for the entire
surgical matched pair cohort (p = 0.008) and for the surgically treated
subgroup with two-vessel disease (p = 0.0002) when compared to the medical
cohort. These results were confirmed by examination of the entire
arteriography registry (n = 1524) in which these seven variables were
known, using Cox's model for survival analysis. This multivariate,
statistical technique indicated that the surgical mode of therapy was
significantly predictive of improved survival in surgically treated
patients for the entire registry (p = 0.008) and for the subgroup with
two-vessel disease (p = 0.0005).
ARTICLES
Evidence from a nonrandomized study that coronary surgery prolongs survival in patients with two-vessel coronary disease
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