Document Detail


Late exercise test results from a prospective randomized study of bypass surgery for stable angina.
MedLine Citation:
PMID:  6345023     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
A prospective randomized study comparing coronary bypass surgery (group 1, 51 patients) to drug therapy (group 2, 49 patients) was initiated in 1981. Supine graded exercise testing (SGXT) was performed initially, at 6 months, and annually with a bicycle ergometer. The presence or absence of ischemic ST segment changes (positive or negative SGXT) and chest pain were recorded. Initially, 63% of all patients had positive SGXT. For group 2, the frequency of positive SGXT results did not change significantly at 6 months (58%) or at 5 years (52%). At 6 months the number of patients without chest pain increased in group 1 compared with group 2 (28/41 vs 13/41, respectively; p less than .002), but there was no difference in the frequency of positive SGXT results (20/41 vs 24/41, respectively; p = NS). This occurred because a majority of the group 1 patients with positive SGXT no longer had associated chest pain (group 1, 11/20, group 2, 3/24; p less than .007). This response was associated with incomplete revascularization in eight of these 11 group 1 patients and may result from "silent ischemia." At 5 years, no significant difference existed in the incidence of positive SGXT (group 1, 10/32 vs group 2, 12/23; p = NS), but group 1 patients continued to have a reduction (although not statistically significant) in the number of patients without chest pain (group 1, 19/32 vs group 2, 7/23). The incidences of death and myocardial infarction were not significantly different between groups. Fewer episodes of unstable angia occurred in group 1 (10/51 vs 19/49; p less than .05). The prognosis of group 1 patients with positive SGXT and no chest pain and incomplete revascularization was not different from that of the entire group.
Authors:
G A Pantely; F E Kloster; C D Morris
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Publication Detail:
Type:  Clinical Trial; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Circulation     Volume:  68     ISSN:  0009-7322     ISO Abbreviation:  Circulation     Publication Date:  1983 Aug 
Date Detail:
Created Date:  1983-08-26     Completed Date:  1983-08-26     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  0147763     Medline TA:  Circulation     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  413-9     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Adult
Angina Pectoris / drug therapy,  physiopathology,  surgery*
Clinical Trials as Topic
Coronary Artery Bypass*
Exercise Test*
Female
Humans
Male
Middle Aged
Pain / etiology
Propranolol / therapeutic use
Prospective Studies
Random Allocation
Grant Support
ID/Acronym/Agency:
1 R01 HL 21293/HL/NHLBI NIH HHS; HL 06336/HL/NHLBI NIH HHS
Chemical
Reg. No./Substance:
525-66-6/Propranolol

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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