Circulation, Vol 68, 939-950, Copyright © 1983 by American Heart Association
CASS includes a multicenter patient registry and a randomized controlled
clinical trial. It is designed to assess the effect of coronary artery
bypass surgery on mortality and selected nonfatal end points. From August
1975 to May 1979, 780 patients with stable ischemic heart disease were
randomly assigned to receive surgical (n = 390) or nonsurgical (n = 390)
treatment and were followed through April 15, 1983. At 5 years, the average
annual mortality rate in patients assigned to surgical treatment was 1.1%.
The annual mortality rate in those receiving medical therapy was 1.6%.
Annual mortality rates in patients with single-, double-, and triple-vessel
disease who were in the surgical group were 0.7%, 1.0%, and 1.5%; the
corresponding rates in patients in the medical group were 1.4%, 1.2%, and
2.1%. The differences were not statistically significant. Nearly 75% of the
patients had entry ejection fractions of at least 0.50. The annual
mortality rates in patients in the surgical group in this subgroup with
single-, double-, and triple-vessel disease were 0.8%, 0.8%, and 1.2% and
corresponding rates in the medical group were 1.1%, 0.6%, and 1.2%. The
annual rate of bypass surgery in patients who were initially assigned to
receive medical treatment was 4.7%. The excellent survival rates observed
both in CASS patients assigned to receive medical and those assigned to
receive surgical therapy and the similarity of survival rates in the two
groups of patients in this randomized trial lead to the conclusion that
patients similar to those enrolled in this trial can safely defer bypass
surgery until symptoms worsen to the point that surgical palliation is
required.
ARTICLES
Coronary artery surgery study (CASS): a randomized trial of coronary artery bypass surgery. Survival data
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H. Samady, J. A. Elefteriades, B. G. Abbott, J. A. Mattera, C. A. McPherson, and F. J. Th. Wackers Failure to Improve Left Ventricular Function After Coronary Revascularization for Ischemic Cardiomyopathy Is Not Associated With Worse Outcome Circulation, September 21, 1999; 100(12): 1298 - 1304. [Abstract] [Full Text] [PDF]
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P. G. Supino, J. S. Borer, E. M. Herrold, and C. Hochreiter Prognostication in 3-Vessel Coronary Artery Disease Based on Left Ventricular Ejection Fraction During Exercise : Influence of Coronary Artery Bypass Grafting Circulation, August 31, 1999; 100(9): 924 - 932. [Abstract] [Full Text] [PDF]
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W. B. Batchelor, E. D. Peterson, D. B. Mark, J. D. Knight, C. B. Granger, P. W. Armstrong, and R. M. Califf A comparison of U.S. and Canadian cardiac catheterization practices in detecting severe coronary artery disease after myocardial infarction: efficiency, yield and long-term implications J. Am. Coll. Cardiol., July 1, 1999; 34(1): 12 - 19. [Abstract] [Full Text] [PDF]
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H. Schunkert, L. Harrell, and I. F. Palacios Implications of small reference vessel diameter in patients undergoing percutaneous coronary revascularization J. Am. Coll. Cardiol., July 1, 1999; 34(1): 40 - 48. [Abstract] [Full Text] [PDF]
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D. Burkhoff, M. N. Wesley, J. R. Resar, and A. M. Lansing Factors correlating with risk of mortality after transmyocardial revascularization J. Am. Coll. Cardiol., July 1, 1999; 34(1): 55 - 61. [Abstract] [Full Text] [PDF]
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 M. S. Ghotbi and J. G. Ramsay Minimally Invasive Cardiac Surgery: Impact on Resource Usage, Costs, Length of Stay, and Return to Function Seminars in Cardiothoracic and Vascular Anesthesia, July 1, 1999; 3(2): 126 - 135. [Abstract] [PDF]
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W. G. Hundley, C. A. Hamilton, G. D. Clarke, L. D. Hillis, D. M. Herrington, R. A. Lange, R. J. Applegate, M. S. Thomas, J. Payne, K. M. Link, et al. Visualization and Functional Assessment of Proximal and Middle Left Anterior Descending Coronary Stenoses in Humans With Magnetic Resonance Imaging Circulation, June 29, 1999; 99(25): 3248 - 3254. [Abstract] [Full Text] [PDF]
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C SHERLAW-JOHNSON Managing waiting lists for cardiac surgery Heart, June 1, 1999; 81(6): 563 - 563. [Full Text]
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S J Bernstein, B Brorsson, T Åberg, H Emanuelsson, R H Brook, and L Werkö Appropriateness of referral of coronary angiography patients in Sweden Heart, May 1, 1999; 81(5): 470 - 477. [Abstract] [Full Text]
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J S Skinner, M Farrer, C J Albers, H A W Neil, and P C Adams High apolipoprotein AI concentrations are associated with lower mortality and myocardial infarction five years after coronary artery bypass graft surgery Heart, May 1, 1999; 81(5): 488 - 494. [Abstract] [Full Text]
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J Herlitz, I Wiklund, K Caidahl, B W Karlson, H Sjöland, M Hartford, M Haglid, and T Karlsson Determinants of an impaired quality of life five years after coronary artery bypass surgery Heart, April 1, 1999; 81(4): 342 - 346. [Abstract] [Full Text]
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C. J. Mullany, M. B. Mock, M. M. Brooks, S. F. Kelsey, N. M. Keller, K. Sutton-Tyrrell, K. M. Detre, and R. L. Frye Effect of age in the bypass angioplasty revascularization investigation (BARI) randomized trial Ann. Thorac. Surg., February 1, 1999; 67(2): 396 - 403. [Abstract] [Full Text] [PDF]
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F. D. Loop Coronary artery surgery: the end of the beginning Eur. J. Cardiothorac. Surg., December 1, 1998; 14(6): 554 - 571. [Abstract] [Full Text] [PDF]
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A Al-Mohammad, I R Mahy, M Y Norton, G Hillis, J C Patel, P Mikecz, and S Walton Prevalence of hibernating myocardium in patients with severely impaired ischaemic left ventricles Heart, December 1, 1998; 80(6): 559 - 564. [Abstract] [Full Text]
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C. J. Pepine and P. C. Deedwania How Do We Best Treat Patients With Ischemic Heart Disease? Circulation, November 10, 1998; 98(19): 1985 - 1986. [Full Text] [PDF]
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R. G. Favaloro Landmarks in the Development of Coronary Artery Bypass Surgery Circulation, August 4, 1998; 98(5): 466 - 478. [Full Text] [PDF]
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T. Tedoriya, M. Kawasuji, N. Sakakibara, H. Takemura, Y. Watanabe, and R. Hetzer Coronary bypass flow during use of intraaortic balloon pumping and left ventricular assist device Ann. Thorac. Surg., August 1, 1998; 66(2): 477 - 481. [Abstract] [Full Text] [PDF]
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R. Sadanandam, N. Al Khaja, M. A Aziz, and M. A Turner Profile of Coronary Artery Bypass Surgery in United Arab Emirates: Dubai Hospital Experience Asian Cardiovasc Thorac Ann, June 1, 1998; 6(2): 118 - 124. [Abstract] [Full Text] [PDF]
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K.M.A. Hussain, A. Kogan, A.Q. Estrada, G. Kostandy, and A. Foschi Referral Pattern and Outcome in Men and Women Undergoing Coronary Artery Bypass Surgery: A Critical Review Angiology, April 1, 1998; 49(4): 243 - 250. [Abstract] [PDF]
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