Document Detail

Progression of native coronary artery disease at 10 years: insights from a randomized study of medical versus surgical therapy for angina.
MedLine Citation:
PMID:  2229749     Owner:  NLM     Status:  MEDLINE    
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)
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:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial    
Journal Detail:
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:
Created Date:  1990-12-11     Completed Date:  1990-12-11     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  8301365     Medline TA:  J Am Coll Cardiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  1066-70     Citation Subset:  AIM; IM    
Section of Cardiology, Veterans Affairs Hospital, Hines, Illinois 60141.
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MeSH Terms
Angina Pectoris / therapy*
Coronary Angiography*
Coronary Artery Bypass*
Coronary Disease / epidemiology*,  radiography
Follow-Up Studies
Graft Occlusion, Vascular / radiography
Middle Aged
Prospective Studies
Time Factors

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

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