The Nature of Treatment Selection in Coronary Artery Disease
Experience with Medical and Surgical Treatment of a Chronic Disease
This report presents our experience with the medical and surgical management of patients with coronary heart disease and uses this experience to document the role of a computerized medical information system in the long-term management of patients with a chronic disease. Of 781 consecutively evaluated patients, 402 were treated medically and 379 were treated with aortocoronary bypass surgery. At two years post-zero time, more than twice as many surgical survivors were pain free, but the survival was the same in the medical (83%) and surgical (85%) cohorts. The medically and surgically treated patients were compared with respect to 89 baseline characteristics. The cohorts were remarkably similar. Correction for baseline inequalities did not affect the fact that two-year survival was the same in both cohorts. One subgroup was identified in which surgically treated patients had a higher two-year survival. Other subgroups were identified in which therapy did not appear to affect two-year survival.
- Received September 19, 1973.
- Accepted December 20, 1973.
- © 1974 American Heart Association, Inc.