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March 15, 1973New England Journal of Medicine145 citations

Results of Direct Coronary-Artery Surgery for the Treatment of Angina Pectoris

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EAEdwin L. AldermanHMHarvey J. MatlofLWLewis Wexler

Key Result

Direct coronary surgery provided partial or complete relief of angina pectoris in 75% of patients at an average of 11.5 months, correlating directly with angiographic graft patency.

Key Points

  • To evaluate the effectiveness of direct coronary surgery in relieving angina pectoris in patients.
  • Evaluated 102 patients undergoing direct coronary surgery for stable angina pectoris.
  • Assessed outcomes at an average of 11.5 months post-operation.
  • Conducted postoperative angiography on 63 patients to analyze graft patency.
  • Operative mortality rate was 3.9% and early postoperative myocardial infarction rate was 6.9%.
  • 75% of patients experienced partial or complete relief of angina.
  • High correlation found between clinical response and graft patency in postoperative angiography.

Study Design

Type

Cohort (n=102)

Structured PICO

Does direct coronary-artery surgery improve symptoms in patients with stable angina pectoris?

P
Population
102 consecutive patients with stable angina pectoris undergoing direct coronary surgery
I
Intervention
Direct coronary-artery surgery
O
Outcome
Relief of angina pectorispatient reported

Direct coronary surgery provides partial or complete relief of angina pectoris in the majority of patients, which strongly correlates with angiographic graft patency.

Abstract

One hundred and two consecutive patients undergoing direct coronary surgery for the treatment of stable angina pectoris were evaluated extensively an average of 11.5 months after operation. Operative mortality was 3.9 per cent, and the incidence of early postoperative myocardial infarction was 6.9 per cent. Of the 102 patients, 62 per cent experienced complete relief of angina, 13 per cent were moderately improved, 16 per cent were unimproved, and 9 per cent were dead one year after surgery. Patients with prior myocardial infarction had a substantially diminished success rate for relief of angina. Sixty-three patients who had postoperative angiography demonstrated a very high correlation between clinical response and graft patency. We conclude that direct coronary surgery provides partial or complete relief of angina pectoris in 75 per cent of patients, and that this response to operative therapy can be directly related to surgical success as defined by angiographic evidence that the graft is patent.

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Cite This Study

Alderman et al. (1973) conducted a cohort in Stable angina pectoris (n=102). Direct coronary-artery surgery was evaluated on Partial or complete relief of angina pectoris. Direct coronary surgery provided partial or complete relief of angina pectoris in 75% of patients at an average of 11.5 months, correlating directly with angiographic graft patency.

synapsesocial.com/papers/6a0d3d4a36162e2f4b09a882https://doi.org/10.1056/nejm197303152881101
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