Improvement in long-term prognosis by coronary bypass surgery in patients with 3-vessel coronary disease--a matched case control study.
We compared survival patterns in 61 medically treated and 78 surgically treated patients at a Japanese community hospital. The 2 groups were matched for presence of significant 3 vessel disease, resting ejection fraction of more than 40%, a bypassable left anterior descending artery, sex, and age. All surgical patients received saphenous vein grafts. The patients treated surgically had better 5 and 9 years survival rates than the medically treated patients (93% and 85% vs 74% and 55%, respectively; p < 0.01 by Cox-Mantel analysis). Five and 9 years rates of absence of ischemic events (non-fatal myocardial infarction and primary cardiac death) were also better in the surgical group than the medical group (92% and 87% vs 66% and 52%, respectively; p < 0.001). Of the surgically treated patients, 5 died perioperatively, 3 had late cardiac deaths and 2 had a nonfatal infarction. Among the medically treated patients, 16 had cardiac deaths, and 6 had non-fatal infarctions. Although our study was non-randomized, we have shown an advantage for surgical treatment of patients with 3-vessel coronary disease.
Chino
M
M
Department of Cardiology, Ashikaga Red Cross Hospital, Tochigi-ken, Japan.
Satoh
T
T
Kusuhara
M
M
Tani
M
M
Yoshino
H
H
Sakai
T
T
Souma
Y
Y
Suzuki
S
S
Nishikawa
K
K
D000368:Aged; D016022:Case-Control Studies; D001026:Coronary Artery Bypass / Q000379:methods / Q000401:mortality*; D003327:Coronary Disease / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D005260:Female; D006801:Humans; D007564:Japan / Q000453:epidemiology; D008297:Male; D011379:Prognosis; D012501:Saphenous Vein / Q000637:transplantation; D013318:Stroke Volume; D015996:Survival Rate; D016277:Ventricular Function, Left / Q000502:physiology