Coronary artery bypass surgery was associated with improved survival compared to medical therapy among 5809 patients, particularly those with severe coronary disease or adverse prognostic indicators.
Cohort (n=5,809)
To elucidate the factors associated with improved survival following coronary artery bypass surgery, we studied 5809 patients receiving medical or surgical therapy for coronary artery disease. Three factors were associated with a significant surgical survival benefit: more severe coronary disease, a worse prognosis with medical therapy, and a more recent operative date. Patients with more extensive coronary obstruction had the greatest improvement in survival. Patients with a poor prognosis because of factors such as older age, severe angina, or left ventricular dysfunction had a reduction in risk that was proportionate to their overall risk on medical therapy. Survival with surgery progressively improved over the study period and by 1984 surgery was significantly better than medical therapy for most patient subgroups. Thus, contemporary coronary revascularization is associated with improved longevity in many patients with ischemic heart disease, especially in those with adverse prognostic indicators.
Robert M. Califf (Fri,) conducted a cohort in Coronary artery disease (n=5,809). Coronary artery bypass surgery vs. Medical therapy was evaluated on Survival. Coronary artery bypass surgery was associated with improved survival compared to medical therapy among 5809 patients, particularly those with severe coronary disease or adverse prognostic indicators.