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September 22, 1977New England Journal of Medicine482 citations

Treatment of Chronic Stable Angina

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MMMarvin L. MurphyHHHerbert N. HultgrenKDKatherine M. Detre

Key Points

  • To evaluate the effect of saphenous-vein-bypass grafting on survival compared to medical treatment in patients with chronic stable angina.
  • Prospective randomized trial enrolling 596 patients with chronic stable angina without left-main-coronary-artery disease.
  • Participants were randomized to medical treatment (N=310) or saphenous-vein-bypass grafting (N=286), with a minimum follow-up duration of 21 months.
  • Operative mortality at 30 days was 5.6%, with 69% overall graft patency and 88% of surgical patients exhibiting at least one patent graft at one year postoperatively.
  • No statistically significant difference in survival occurred at a minimum follow-up of 21 months, with 36-month survival rates reaching 87% in the medical group versus 88% in the surgical group.

Abstract

We evaluated the effect of saphenous-vein-bypass grafting on survival in patients with chronic stable angina by comparing medical and surgical treatment in a large-scale, prospective randomized study. Excluding patients with left-main-coronary-artery disease who have already been reported, a total of 596 patients were entered into this study; when randomized into a medical group (310 patients) and a surgical group (286 patients), entry clinical and angiographic base lines were comparable. Operative mortality at 30 days was 5.6 per cent. At an average of one year after operation, 69 per cent of all grafts were patent, and 88 per cent of the surgical patients had atleast one patent graft. There was no statistically significant difference in survival, at a minimal follow-up interval of 21 months, between patients treated medically and those treated with saphenous-vein-bypass grafting. At 36 months, 87 per cent of the medical group and 88 per cent of the surgical group were alive.

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Cite This Study

Murphy et al. (1977) studied this question.

synapsesocial.com/papers/6a7cd76d413d908bbb8d1855https://doi.org/10.1056/nejm197709222971201
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Also Consider

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