Effect of completeness of revascularization on long-term outcome of patients with three-vessel disease undergoing coronary artery bypass surgery. A report from the Coronary Artery Surgery Study (CASS) Registry.
Key result
Complete revascularization (grafts to ≥3 vessels) improved 6-year survival compared to 2 vessels in patients with severe angina and ejection fraction <0.35 (69% vs 45%, p=0.04).
Why the study?
Does complete revascularization improve survival and event-free survival in patients with three-vessel coronary disease undergoing coronary artery bypass surgery?
Population
3,372 nonrandomized surgical patients from the Coronary Artery Surgery Study Registry with three-vessel…
Comparison
Complete revascularization vs Incomplete revascularization
Design
Cohort
Follow-up
up to 6 years
Authors
Discussion
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Member takes
Implication
Supports complete revascularization in severe angina with EF<0.35; leaves open need for randomized confirmation in three-vessel disease.
Study Design
Type
Cohort (n=3,372)
Multicenter
Yes
Structured PICO
Does complete revascularization improve survival and event-free survival in patients with three-vessel coronary disease undergoing coronary artery bypass surgery?
P
Population
3,372 nonrandomized surgical patients from the Coronary Artery Surgery Study (CASS) Registry with three-vessel coronary disease undergoing coronary artery bypass surgery. Group 1 (n=894) had class I or II angina; Group 2 (n=2,478) had class III or IV angina.
I
Intervention
Complete revascularization (grafts to three or more vessels)
C
Comparator
Incomplete revascularization (grafts to one or two vessels)
O
Outcome
Survival and event-free survival (composite of death, myocardial infarction, definite angina, or reoperation)composite
Main Result
Absolute Event Rate: 69% vs 45%
p-value: p=0.04
Complete revascularization during CABG in patients with three-vessel disease provides the greatest survival and event-free survival benefits to those with severe angina and left ventricular dysfunction.
Cite This Study
Bell et al. (1992) conducted a cohort in Three-vessel coronary disease (n=3,372). Complete revascularization (grafts to ≥3 vessels) vs. Less complete revascularization (grafts to 1 or 2 vessels) was evaluated on 6-year survival in patients with severe angina and ejection fraction <0.35 (p=0.04). Complete revascularization (grafts to ≥3 vessels) improved 6-year survival compared to 2 vessels in patients with severe angina and ejection fraction <0.35 (69% vs 45%, p=0.04).