Author + information
- Received December 7, 1987
- Revision received March 16, 1988
- Accepted April 7, 1988
- Published online January 1, 1988.
- Donald A. Weiner, MD, FACC*,1,
- Thomas J. Ryan, MD, FACC*,
- Carolyn H. McCabe, BS*,
- Bernard R. Chaitman, MD, FACC†,
- L. Thomas Sheffield, MD, FACC‡,
- Grace Ng, BS§,
- Lloyd D. Fisher, PhD*,
- Felix E. Tristini, MD, FACC‖,
- The Cass Investigators¶
- ↵1Address for reprints: Donald A. Weiner, MD, Section of Cardiology, The University Hospital, 88 East Newton Street, Boston, Massachusetts 02118.
To determine whether coronary artery bypass surgery would prolong survival in patients with silent myocardial ischemia during exercise testing, the data on 692 such patients from the Coronary Artery Surgery Study (CASS) registry were analyzed. The patients were followed up for up to 7 years after medical (n = 424) or surgical (n = 268) therapy. Stratification of patients into subsets was based on the results of cardiac catheterization.
Surgical benefit was greatest in the patients with three vessel coronary artery disease or abnormal left ventricular function. Among the 75 patients with three vessel coronary disease and left ventricular dysfunction, the 7 year survival rate was 37% for the medical group and 90% for the surgical group (p < 0.0001). Thus, among patients with silent myocardial ischemia during exercise testing in this nonrandomized study, survival appeared to be enhanced by coronary artery bypass surgery in subsets of patients with severe coronary artery disease and abnormal left ventricular function.
↵¶ A list of CASS investigators and clinical centers appears in the Appendix.
This study was presented in part at the 36th Scientific Session of the American College of Cardiology, New Orleans, Louisiana, March 1987. This study was supported in part by Grant I HV62923 from the National Institutes of Health, Bethesda, Maryland.
- Received December 7, 1987.
- Revision received March 16, 1988.
- Accepted April 7, 1988.
- American College of Cardiology