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Circulation, Vol 68, 951-960, Copyright © 1983 by American Heart Association
To evaluate the comparative effects of medical and surgical therapy on
quality of life of patients with stable ischemic heart disease, 780
patients who had been randomly assigned to medical or surgical therapy in
the CASS were systematically followed for a mean of 5.5. years. Analysis
was performed according to original treatment assignment. Patients in the
surgical group had significantly less chest pain, fewer activity
limitations, and required less therapy with nitrates and beta- blockers.
Treadmill exercise tests performed 6, 18, and 60 months after entry
documented significantly longer treadmill time, less exercise- induced
angina, and less ST segment depression among surgical group patients.
However, employment status and recreational status did not differ
significantly between medical and surgical groups. Total number of
hospitalizations after randomization was higher in the surgical group owing
primarily to rehospitalization during the first year of follow-up for the
coronary artery bypass graft surgery. Risk factors, including high blood
pressure, cigarette smoking, high cholesterol levels, overweight, and poor
exercise habits remained similar between medical and surgical groups. This
randomized collaborative study shows that coronary artery bypass graft
surgery improves the quality of life as manifested by relief of chest pain,
improvement in both subjective and objective measurements of functional
status, and a diminished requirement for drug therapy. However, no
significant effect on employment or recreational status was observed.
ARTICLES
Coronary artery surgery study (CASS): a randomized trial of coronary artery bypass surgery. Quality of life in patients randomly assigned to treatment groups
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