[Severity of stabilized angina pectoris and indication for coronary bypass-implications for prognosis].
The prognosis in patients with mild or moderate angina pectoris (class I or I-II) and significant coronary artery lesions (70% or more luminal diameter reduction) is controversial. Since 1967 these cases have not been operated upon in our Division. To assess the justice of this approach, 61 mildly symptomatic, non-operated patients (group I) were compared with 65 markedly symptomatic (class II to IV) patients in whom coronary artery bypass procedures were indicated but not performed (group II). These patients either had refused surgery or the lesions were considered unsuited to revascularization. Although 44 patients in group I had 70% or more stenosis of one or more coronary arteries, the 8-year mortality rate in group I was 17% compared with 40% in group II. For patients with single vessel disease (32 patients in group I, 35 patients in group II) the 8-year mortality was 9.4% in group I and 34% in group II; the difference is significant. This retrospective study suggests that mild and moderate angina pectoris (class I or I-II with or without medical treatment) is associated with a rather favourable prognosis (one single death during the first four years in group I). It may be concluded that an aggressive approach can be delayed until further symptoms develop despite adequate medical therapy.
D000787:Angina Pectoris / Q000175:diagnosis* / Q000503:physiopathology / Q000601:surgery; D001026:Coronary Artery Bypass; D003326:Coronary Circulation; D003331:Coronary Vessels / Q000503:physiopathology; D006801:Humans; D011379:Prognosis; D012189:Retrospective Studies; D013557:Switzerland
Sévérité de l'angine de poitrine stable et indication au pontage coronarien-implication pour le pronostic.