title: Survival of patients with well-developed collaterals undergoing CABG or medical treatment: an observational case-controlled study.
abstract: OBJECTIVE
  The effects of coronary artery bypass grafting (CABG) on mortality have not been evaluated in patients with well-developed coronary collaterals. We investigated functional capacity, presence of angina, the occurrence of acute myocardial infarction, survival and mortality in patients with well-developed coronary collaterals both undergoing and refusing CABG.
  
  
  METHODS
  The study was designed as a retrospective observational case-controlled study. Seventy-eight patients undergoing coronary angiography were included in this study. They had critical occlusion in the proximal left anterior descending artery (LAD) with Rentrop-3 collateral circulation towards LAD, and to proceed with CABG has been suggested. The patients were divided in two groups; first group proceeding with CABG (n=40) and the second, rejecting the surgery (medical treatment group; n=38). The rates of survival, the incidence of angina pectoris and acute myocardial infarction as well as the functional capacities were evaluated in all patients. Survival rates were evaluated using Kaplan-Meier survival analysis.
  
  
  RESULTS
  No statistically significant difference was observed between the two groups regarding the baseline characteristics of patients, the presence of angina pectoris, the severity of angina pectoris according to CCS, the occurrence of acute myocardial infarction or stroke, and the functional capacity according to NYHA (p>0.05). Death due to cardiovascular reasons was observed in eight patients of CABG group and in five patients of medical treatment group (p=0.710). The 5-year survival rate was observed to be 80% in CABG group while it was observed to be 84% in the medical treatment group (p=0.730).
  
  
  CONCLUSIONS
  There was no significant difference regarding the survival rates in patients with well-developed coronary collaterals proceeding with CABG or medical treatment.
authors.affiliation: Clinic of Cardiology, Ada Tıp Hospital, Sakarya-Turkey. ersantatli@yahoo.com
authors.forename: Ersan
authors.initials: E
authors.lastname: Tatlı
authors.forename: Meryem
authors.initials: M
authors.lastname: Aktoz
authors.forename: Mehmet Akif
authors.initials: MA
authors.lastname: Çakar
authors.forename: Emir
authors.initials: E
authors.lastname: Doğan
authors.forename: Mustafa
authors.initials: M
authors.lastname: Alkan
authors.forename: Bilhan
authors.initials: B
authors.lastname: Özalp
mesh_terms: D000787:Angina Pectoris / Q000209:etiology; D016022:Case-Control Studies; D001026:Coronary Artery Bypass; D003324:Coronary Artery Disease / Q000150:complications / Q000401:mortality / Q000503:physiopathology / Q000601:surgery*; D003331:Coronary Vessels / Q000503:physiopathology; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D009203:Myocardial Infarction / Q000209:etiology; D012189:Retrospective Studies; D016019:Survival Analysis; D014421:Turkey