Author + information
- Received September 19, 1994
- Revision received May 16, 1995
- Accepted May 24, 1995
- Published online October 1, 1995.
- ↵*Address for correspondence: Dr. Airlie A. C. Cameron, Division of Cardiology, St. Luke's-Roosevelt Hospital Center, Ill I Amsterdam Avenue, New York, New York 10025.
Objectives. This study sought to define the predictors and prognosis of postoperative angina in patients undergoing coronary artery bypass surgery.
Background. Angina recurs in the first postoperative year in 20% to 30% of patients after coronary artery bypass surgery. The Coronary Artery Surgery Study Registry provides an opportunity to study the predictors and prognosis of postoperative angina in a large sample.
Methods. All patients with isolated coronary artery bypass surgery in the registry were identified, and anginal status was determined on a yearly basis. The influence of angina on mortality, recurrent myocardial infarction and need for reoperation was determined.
Results. Angina recurred in the first year in 24% of patients and by the sixth year in 40%. The significant predictors in a multivariate analysis were minimal coronary artery disease, preoperative angina, use of vein grafts only, previous myocardial infarction, incomplete revascularization, female gender, smoking and younger age. In subsequent years important predictors were angina in the first postoperative year, female gender, younger age and incomplete revascularization. The presence of angina in the first postoperative year was associated with more frequent myocardial infarction (p = 0.04) and greater need for reoperation (p = 0.003) but did not affect survival during the 6-year follow-up period.
Conclusions. These findings show that the predictors of postoperative angina are features that are or could be predicted before bypass surgery. Thus, patients with these features before bypass surgery could be advised that they would be more likely to experience postoperative angina than those without these features. Postoperative angina is associated with an increased risk of late myocardial infarction and reoperation.
This study was presented in part at the 63rd Annual Scientific Sessions of the American Heart Association, Dallas, Texas, November 1990. The Coronary Artery Surgery Study (CASS) was funded by the National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Maryland.
- Received September 19, 1994.
- Revision received May 16, 1995.
- Accepted May 24, 1995.
- American College of Cardiology