The Annals of Thoracic Surgery, Vol 37, 52-59, Copyright © 1984 by The Society of Thoracic Surgeons
Enhanced late survival following coronary artery bypass graft operation for unstable versus chronic angina
A Cobanoglu, I Freimanis, G Grunkemeier, L Lambert, V Anderson, D Nunley, C Garcia and A Starr
Late survival following coronary artery bypass operation is time-frame
dependent, with a major improvement occurring by 1974. In the cohort of
patients undergoing operation between 1974 and mid-1982, subsets were
present with further enhanced survival. In this study of 3,575 patients,
the urgency of clinical presentation is examined as a survival determinant,
and the results are seemingly paradoxical. Among the 1,404 patients with
chronic angina, survival at 1 month was 98.3%; at 5 years, 88%; and at 8
years, 79%. Among the 1,008 patients with progressive angina, survival at 1
month was 97.8%; at 5 years, 90%; and at 8 years, 80%. Among the 1,163
patients with unstable angina, 1-month survival was 98.3%; 5-year survival,
92%; and 8-year survival, 89%. The best long-term results were obtained in
patients with an acute clinical presentation. Ventricular function was an
important determinant of late survival for the groups with chronic (p less
than 0.001) and progressive (p less than 0.001) angina, but it had no
effect in the group with unstable angina (p = 0.803). For the patients with
chronic angina and good left ventricular (LV) function, survival was 99.5%
at 1 month; 92% at 5 years; and 86% at 8 years. For those with poor LV
function, the respective survival was 96%, 84%, and 71%. For the patients
with progressive angina and good LV function, 1-month survival was 98.9%;
5-year survival, 94%; and 8-year survival, 83%. For those with poor LV
function, the respective figures were 96.3%, 85%, and 76%. For the patients
with unstable angina and good LV function, survival at 1 month was 97.8%;
at 5 years, 92%; and at 8 years, 89%.(ABSTRACT TRUNCATED AT 250 WORDS)
