[Medium term outcome of 191 cases of coronary insufficiency technically operable and treated medically].
After evaluation by clinical examination, stress testing and coronary angiography, coronary patients may be classified into several subgroups according to the therapeutic orientation: 1) surgical and operable, 2) surgical but inoperable, 3) operable, but not immediately, 4) inoperable and not referred for operation. Groups 1 and 2 have severe ischaemia at rest or on exercise and an incomplete response to medical therapy: surgical revascularisation may be possible (Group 1) or not (Group 2). The surgical indication in Group 4 is not formal, but would be this so the operation would not be possible technically: this is the case for example in isolated thrombosis of the right coronary or left anterior descending arteries after infarction in their territories. This study concerns cases in Group 3; a total of 196 patients were deliberately treated medically after exercise stress testing had indicated a probable good prognosis despite patent coronary lesions (1.76 vessels with over 70% stenosis or thrombosis). Of the 1,181 patients who underwent exercise stress testing without therapy before coronary angiography between January 1979 and March 1983, 700 were operated (Group 1), 200 were inoperable (Group 2), 50 were inoperable and not referred for surgery (Group 4) and 196 were deliberate abstentions (Group 3); 35 patients underwent angioplasty; the average age of these 196 patients (168 men and 27 women) was 57.6 +/- 9 years (range 29 to 76 years). The incidence of single, double and triple vessel disease in this subgroup was 42%, 38% and 20%, respectively; 37% had previous infarction; 16% had atypical chest pain; 40% had stable angina, recent in 44% of cases.(ABSTRACT TRUNCATED AT 250 WORDS)
D000328:Adult; D000368:Aged; D003327:Coronary Disease / Q000503:physiopathology* / Q000628:therapy; D005080:Exercise Test; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D011379:Prognosis; D012189:Retrospective Studies; D013997:Time Factors
Devenir à moyen terme de 191 cas d'insuffisance coronaire techniquement opérables et traités médicalement.