Key result
Coronary artery bypass surgery combined with medical therapy produces a greater degree of improvement in symptomatic state and functional class than medical therapy alone.
Why the study?
Does coronary artery bypass surgery combined with medical therapy improve symptomatic state and functional class in patients with severe coronary artery disease?
Does coronary artery bypass surgery combined with medical therapy improve symptomatic state and functional class in patients with severe coronary artery disease?
Coronary artery bypass surgery combined with medical therapy provides superior symptomatic and functional improvement compared to medical therapy alone in patients with severe coronary artery disease.
May support CABG for symptom relief in severe CAD; Level 5 review leaves open need for contemporary RCTs.
Many studies have demonstrated that coronary artery bypass surgery combined with medical therapy produces a greater degree of improvement in the symptomatic state and in the functional class of the patients with severe coronary artery disease than does medical therapy alone. This can be objectively documented by an improvement in the exercise capacity and by an increase in heart rate and blood pressure attained at the higher level of exercise. The improvement is the result of relief of exercise-induced (and resting) myocardial ischemia documented by increases in heart rate and blood pressure, greater lactate extraction across the myocardium, improvement in left ventricular dysfunction, abolition of exertional hypotension, and by reversal of exercise-induced and of resting thallium-201 defects. Results of coronary bypass surgery performed during 1974-1979 are better than those during 1969-1973.
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S H Rahimtoola (1982) conducted a review in Severe coronary artery disease. Coronary artery bypass surgery combined with medical therapy vs. Medical therapy alone was evaluated on Symptomatic state and functional class. Coronary artery bypass surgery combined with medical therapy produces a greater degree of improvement in symptomatic state and functional class than medical therapy alone.
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