Circulation, Vol 83, 87-95, Copyright © 1991 by American Heart Association
DC Booth, RH Deupree, HN Hultgren, AN DeMaria, SM Scott and RJ Luchi
To assess the effect of bypass surgery on outcome from unstable angina, 468
patients were randomized to medical treatment (237 patients) or surgery
plus medical treatment (231 patients) and have been followed for comparison
of survival, cardiac end points, and quality of life; the latter end point
is discussed in the present report. Data were available at 3 and 5 years
for 80% and 82% of patients in the medical group, respectively, and 77% and
80% of patients in the surgery group, respectively. At 3 months after
randomization to therapy, 79.8% of patients in the surgery group reported
subjective improvement, compared with 58% of the medical group, 12.6% of
the surgery group reported no change compared with 24.5% of the medical
group, and 5.5% of the surgery group reported worsening compared with 24.5%
of the medical group (p less than 0.01 by chi 2). Similar data were found
for chest pain status, and the benefit to the surgery group remained
statistically significant through 5 years of follow-up. Crossover rate to
surgery was 43% by 5 years. Treadmill duration was increased in the surgery
group compared with the medical group (6.5 +/- 0.25 versus 5.3 +/- 0.25
minutes at 6 months, p less than 0.01), and a significant difference was
again demonstrated at 3 and 5 years. A trend toward decreased recurrence of
unstable angina was present in the surgery group at 1 year (six of 168
[3.6%] versus 13 of 187 [6.9%] in the medical group, p = 0.158), but the
two groups were similar at 3 and 5 years.(ABSTRACT TRUNCATED AT 250 WORDS)
ARTICLES
Quality of life after bypass surgery for unstable angina. 5-year follow- up results of a Veterans Affairs Cooperative Study
Department of Veterans Affairs Medical Centers, Lexington, Ky.
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