This Article Alert me when this article is cited Alert me if a correction is posted Services Email this article to a friend Similar articles in this journal Alert me to new issues of the journal Download to citation manager Request Permissions Citing Articles Citing Articles via HighWire Citing Articles via Google Scholar Google Scholar Articles by Loeb, H. S. Articles by Gunnar, R. M. Search for Related Content PubMed Articles by Loeb, H. S. Articles by Gunnar, R. M.

Circulation, Vol 60, 22-30, Copyright © 1979 by American Heart Association

ARTICLES

Improved survival after surgical therapy for chronic angina pectoris: one hospital's experience in a randomized trial

HS Loeb, R Pifarre, H Sullivan, R Palac, RP Croke and RM Gunnar

Between 1972 and 1974, 121 patients with chronic stable angina pectoris and operative coronary artery disease, excluding significant left main coronary obstruction, were randomized to either medical therapy (60 patients) or surgical therapy (61 patients) as part of a larger Veterans Administration Cooperative Study of Surgery for Coronary Arterial Occlusive Disease. At the time of randomization, medical and surgical groups were similar with regard to clinical and hemodynamic features as well as degree of left ventricular impairment and extent of coronary disease. Follow-up to June 1, 1978, reveals significantly improved survival in surgical patients from 3 through 6 years after randomization. Sixteen cross-over patients (13 medical to surgery, and 3 surgical without surgery) do not appear to influence results. Results of this randomized study from a single hospital differ from the preliminary results of the larger cooperative study, primarily because of a higher mortality in the medical group. The medical mortality in our group is in keeping with other reports of the natural history of patients with angina pectoris, and we propose that the population of patients we randomized closely simulates the usual type of patient with chronic angina being considered for surgical treatment. Our good surgical results thus contrast significantly with the survival of medically treated patients, and this separates our study from the body of the Veterans Administration Cooperative Study.

This article has been cited by other articles:

				R. M. Gunnar Decision Analysis in the Evaluation of Revascularization Ann Intern Med, December 1, 1990; 113(11): 817 - 818. [Abstract] [PDF]

				S. H. Rahimtoola, G. L. Grunkemeier, J. F. Teply, L. E. Lambert, D. R. Thomas, Y.-F. Suen, and A. Starr Changes in Coronary Bypass Surgery Leading to Improved Survival JAMA, October 23, 1981; 246(17): 1912 - 1916. [Abstract] [PDF]