What is the role of coronary bypass surgery in patients with chronic angina?
As we learn more about CAD, its presentation, clinical characteristics, and "natural" history, we have begun to realize the enormous variability of the "natural" history of this disease, depending on clinical, electrocardiographic, stress-testing, arteriographic, and ventricular function data. Therefore, it seems likely that we may not be able to be certain that CBS prolongs life in any subgroup of patients with CAD without a prospective randomized study that is properly designed and rigorously conducted. However, it has to be acknowledged that for practical purposes this goal may be extremely difficult to achieve. Left ventricular function and the number of diseased vessels are the most powerful predictors and determinants of survival. Age, functional class, type of angina, ECG, and heart size are other major determinants of survival. Progressive chest pain is a powerful predictor of total cardiac events, particularly of nonfatal myocardial infarction in patients with one- and two-vessel disease and of cardiac deaths in patients with three-vessel disease and LMCAD.
D000787:Angina Pectoris / Q000150:complications / Q000601:surgery* / Q000628:therapy; D001157:Arterial Occlusive Diseases / Q000503:physiopathology; D002908:Chronic Disease; D003251:Constriction, Pathologic; D017023:Coronary Angiography; D001026:Coronary Artery Bypass / Q000009:adverse effects / Q000401:mortality / Q000639:trends; D003327:Coronary Disease / Q000145:classification / Q000401:mortality / Q000601:surgery; D003971:Diastole; D005260:Female; D006352:Heart Ventricles / Q000000981:diagnostic imaging; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D009204:Myocardial Revascularization; D011877:Radionuclide Imaging; D011897:Random Allocation; D012306:Risk; D013318:Stroke Volume