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Circulation, Vol 68, 986-997, Copyright © 1983 by American Heart Association

ARTICLES

Fifteen year survival study of patients with obstructive coronary artery disease

WJ Proudfit, AV Bruschke, JP MacMillan, GW Williams and FM Sones Jr

Survival rates were determined for a group of 598 patients in whom severe coronary disease was demonstrated by arteriography; initially they were treated medically and were followed-up for 15 years. Deaths due to noncoronary causes were uncommon (5% of total) in the first 5 year period but were frequent (36%) in the third period. Survival rates were 48%, 28%, 18%, and 9% for patients with single-, double-, triple-, and left main artery disease, respectively. Abnormalities documented by ventriculography were related to survival. In 386 patients who would have been candidates for bypass surgery, survival rates were 58%, 35%, 26%, and 11% for those with single-, double-, triple-, and left main artery disease, respectively. Cardiac survival curves for single-, double-, and triple-artery disease in candidates for surgery and curves constructed on the basis of 3% mortality per artery per year corresponded fairly closely. When an abnormal electrocardiogram (ECG) is considered as a single variable in multivariate analysis, 5 year survival rates of candidates for surgery were influenced by the following in order of importance: abnormal ECG, symptoms at least 5 years in duration, triple-artery disease, double-artery disease, and arteriosclerosis obliterans. A simple prognostic stratification was devised that used only ECGs and duration of symptoms for each subset based on the number of arteries affected.

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