Document Detail


Medical versus surgical therapy for acute coronary insufficiency. A randomized study.
MedLine Citation:
PMID:  810719     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Forty patients with acute coronary insufficiency, including continued angina at rest and reversible ischemic electrocardiographic changes after hospitalization ("high-risk" subgroup), were randomly allotted to medical therapy or urgent surgical coronary bypass groups. In four months there were no deaths and two myocardial infarctions in 19 medical patients and one death and three myocardial infarctions in 21 surgical patients. Left ventricular ejection fraction did not change significantly in either group. The surgical patients had significantly higher functional capacities at four months as judged by lower symptomatic functional class (P less than 0.01), higher exercise angina threshold (P less than 0.001), higher pacing angina threshold (P less than 0.0001), and higher myocardial lactate extraction during pacing (P less than 0.0001). Initial medical management of patients with acute coronary insufficiency followed by elective coronary bypass in patients with continued disabling angina pectoris is a reasonable alternative to emergency bypass.
Authors:
R Selden; W A Neill; L W Ritzmann; J E Okies; R P Anderson
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, Non-P.H.S.; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  The New England journal of medicine     Volume:  293     ISSN:  0028-4793     ISO Abbreviation:  N. Engl. J. Med.     Publication Date:  1975 Dec 
Date Detail:
Created Date:  1976-02-02     Completed Date:  1976-02-02     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  0255562     Medline TA:  N Engl J Med     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1329-33     Citation Subset:  AIM; IM    
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MeSH Terms
Descriptor/Qualifier:
Acute Disease
Adult
Angina Pectoris / drug therapy,  mortality,  surgery,  therapy*
Coronary Artery Bypass* / adverse effects
Exercise Test
Follow-Up Studies
Hospitalization
Humans
Middle Aged
Myocardial Infarction / epidemiology
Nitroglycerin / therapeutic use
Oxygen Inhalation Therapy
Propranolol / administration & dosage,  therapeutic use
Prospective Studies
Recurrence
Chemical
Reg. No./Substance:
525-66-6/Propranolol; 55-63-0/Nitroglycerin

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


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