Prognostication in 3-Vessel Coronary Artery Disease Based on Left Ventricular Ejection Fraction During Exercise
Why the study?
Does coronary artery bypass grafting improve outcomes compared to medical therapy in patients with 3-vessel CAD stratified by exercise-induced changes in LVEF?
Population
167 stable patients with angiographically documented 3-vessel CAD who previously had undergone rest and…
Comparison
Coronary artery bypass grafting vs Medical treatment only (n=52)
Design
Cohort
Follow-up
average 9 years
Authors
Discussion
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Member takes
Implication
Exercise ΔLVEF ≤−8% may identify 3-vessel CAD patients for early CABG consideration; leaves open randomized confirmation.
Structured PICO
Does coronary artery bypass grafting improve outcomes compared to medical therapy in patients with 3-vessel CAD stratified by exercise-induced changes in LVEF?
P
Population
167 stable patients with angiographically documented 3-vessel CAD who previously had undergone rest and exercise radionuclide cineangiography
I
Intervention
Coronary artery bypass grafting (CABG) (n=115, 44 early [≤1 month after initial study])
C
Comparator
Medical treatment only (n=52)
O
Outcome
Major cardiac events and cardiac deathhard clinical
Assessment of ischemia severity based on LVEF response to exercise identifies patients with 3-vessel CAD who derive significant survival and event-reducing benefits from early CABG.
Cite This Study
Supino et al. (1999) studied this question.