| Progression of native coronary artery disease at 10 years: insights from a randomized study of medical versus surgical therapy for angina. | |
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MedLine Citation:
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PMID: 2229749 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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Repeat coronary angiography was performed in 42 patients 10 years after randomization to medical (n = 21) or surgical (n = 21) therapy for chronic angina. The native coronary arteries were classified into 15 angiographic segments and 3 arterial trunks for analysis of progression of coronary artery disease. The incidence rate of disease progression in coronary segments was 24% and 28% in medically and surgically treated patients, respectively (p = NS). Grafted segments showed a 38% rate of disease progression, which was higher than the 18% rate of for nongrafted segments (p less than 0.001) and the overall rate of 24% for medically treated patients (p less than 0.01). Similarly, 29 (94%) of 31 grafted arteries exhibited disease progression compared with 19 (59%) of 32 nongrafted arteries (p less than 0.01) and 42 (67%) of 63 arteries in medically treated patients (p less than 0.01). In grafted vessels, disease progression occurred more often in arteries proximal (84%) to the anastomosis than in arteries distal (16%) to graft insertion (p less than 0.001). Progression occurred in 46% of proximal segments compared with 23% of distal segments (p less than 0.02). Progression was seen in 23 (55%) of 43 segments with an occluded graft compared with 30 (31%) of 96 segments with a patent graft (p less than 0.02). Ten years after randomization, medically and surgically treated patients showed a comparable rate of disease progression in coronary segments. However, surgical therapy appeared to significantly accelerate atherosclerotic progression in the grafted vessels, especially in the proximal portions. Occluded grafts also correlated with an adverse effect on disease progression.(ABSTRACT TRUNCATED AT 250 WORDS) |
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Authors:
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M H Hwang; W R Meadows; R T Palac; Z E Piao; R Pifarre; H S Loeb; R M Gunnar |
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Publication Detail:
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Type: Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial |
Journal Detail:
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Title: Journal of the American College of Cardiology Volume: 16 ISSN: 0735-1097 ISO Abbreviation: J. Am. Coll. Cardiol. Publication Date: 1990 Nov |
Date Detail:
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Created Date: 1990-12-11 Completed Date: 1990-12-11 Revised Date: 2006-11-15 |
Medline Journal Info:
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Nlm Unique ID: 8301365 Medline TA: J Am Coll Cardiol Country: UNITED STATES |
Other Details:
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Languages: eng Pagination: 1066-70 Citation Subset: AIM; IM |
Affiliation:
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Section of Cardiology, Veterans Affairs Hospital, Hines, Illinois 60141. |
Export Citation:
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APA/MLA Format Download EndNote Download BibTex |
| MeSH Terms | |
Descriptor/Qualifier:
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Angina Pectoris
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therapy* Angiography Coronary Angiography* Coronary Artery Bypass* Coronary Disease / epidemiology*, radiography Follow-Up Studies Graft Occlusion, Vascular / radiography Humans Incidence Middle Aged Prospective Studies Time Factors |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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