Document Detail

Ten-year results of the randomized control trials of coronary artery bypass graft surgery: tabular data compiled by the collaborative effort of the original trial investigators. Part 1 of 2.
MedLine Citation:
PMID:  7804524     Owner:  NLM     Status:  MEDLINE    
OBJECTIVE: To make available 10-year mortality data compiled and analyzed on patients with stable coronary heart disease (angina not severe enough to necessitate surgery) from all studies in which patients were randomized to initial coronary artery bypass graft (CABG) surgery or initial medical treatment and to determine whether the effects are influenced by the extent of coronary artery disease and degree of left-ventricular function. Data and analyses are presented in tabular form; text is published simultaneously in Lancet. METHODS: We collected individual patient data using standardized forms and, whenever possible, uniform definitions. We used Mantel-Haentel methods to combine data. Restricted means analyses were applied to quantify the extension in survival, and logistic regression analyses were applied to assess whether any baseline covariate affected the treatment differences. RESULTS: Of 2,649 patients, 1,324 were assigned to receive CABG surgery and 1,325 to the medical group. Mean age was 50.8 years; 98.8% were men. 93.7% of the CABG group underwent surgery. 25% of the medical group had undergone surgery at 5 years, 33% at 7 years, and 41% at 10 years. Initial CABG surgery reduced mortality significantly at 5 years (10.2% vs 15.8%; OR = 0.61; P < 0.001), 7 years (15.8% vs 21.7%; OR = 0.68; P < 0.001), and 10 years (26.4% vs 30.5%; OR = 0.83; P < 0.03). Risk reductions were most pronounced in patients with left-main disease compared to those with 3- or 1-2-vessel disease (at 5 years OR = 0.32, 0.58, and 0.77, respectively). CONCLUSIONS: Initial CABG surgery compared to initial medical management reduces mortality, especially in high- and medium-risk patients.
S Yusuf; D Zucker; T C Chalmers
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Publication Detail:
Type:  Journal Article; Meta-Analysis    
Journal Detail:
Title:  The Online journal of current clinical trials     Volume:  Doc No 145     ISSN:  1059-2725     ISO Abbreviation:  Online J Curr Clin Trials     Publication Date:  1994 Oct 
Date Detail:
Created Date:  1995-02-02     Completed Date:  1995-02-02     Revised Date:  2007-11-15    
Medline Journal Info:
Nlm Unique ID:  9300367A     Medline TA:  Online J Curr Clin Trials     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  [3987 words; 38 paragraphs]     Citation Subset:  IM    
National Heart, Lung, and Blood Institute, Bethesda, MD.
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MeSH Terms
Confidence Intervals
Coronary Artery Bypass / statistics & numerical data*
Coronary Disease / drug therapy,  mortality*,  surgery
Logistic Models
Middle Aged
Multivariate Analysis
Myocardial Infarction / epidemiology
Odds Ratio
Randomized Controlled Trials as Topic
Risk Factors
Survival Analysis

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

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