Author + information
- Received October 8, 1990
- Revision received January 16, 1991
- Accepted February 2, 1991
- Published online August 1, 1991.
- Donald A. Weiner, MD, FACCe,∗,
- Thomas J. Ryan, MD, FACCe,
- Lori Parsons, BS∗,
- Lloyd D. Fisher, PhD, FACC∗,
- Bernard R. Chaitman, MD, FACC†,
- L.Thomas Sheffield, MD, FACC‡ and
- Felix E. Tristani, MD, FACC§
- ↵∗Address for reprints: Donald A. Weiner, MD, Section of Cardiology, The University Hospital, 88 East Newton Street, Boston, Massachusetts 02118.
The prevalence and prognostic significance of postoperative myocardial ischemia, as detected by exercise testing, were prospectively assessed in 174 patients from the Coronary Artery Surgery Study (CASS) randomized surgical population who had exercise testing before and 6 months after coronary artery bypass graft surgery. Whereas the prevalence of symptomatic ischemia significantly decreased postoperatively (52% vs. 6%, p < 0.001), the frequency of silent myocardial ischemia did not change (30% vs. 29%).
Survival at 12 years after bypass surgery based on the 6-month postoperative exercise, test results was significantly better for the 112 patients with no ischemia (80%) than for the 51 patients with silent ischemia (68%) or the 11 patients with symptomatic ischemia (45%).
These data show that coronary artery bypass graft surgery diminishes the overall prevalence of symptomatic but not silent ischemia and that both silent and symptomatic ischemia adversely affect the postoperative prognosis of these patients.
☆ This study was presented in part at the 39th Scientific Sessions of the American College of Cardiology, New Orleans, Louisiana, March 1990.
It was supported in part by Grant I HV62923 from the National Institutes of Health, Bethesda, Maryland.
- Received October 8, 1990.
- Revision received January 16, 1991.
- Accepted February 2, 1991.