The Annals of Thoracic Surgery, Vol 42, 3-8, Copyright © 1986 by The Society of Thoracic Surgeons
CABG: lessons from the randomized trials
GC Kaiser
Three large cooperative randomized trials have evaluated the effects of
medical and surgical management of ischemic heart disease on survival and
other secondary end points. Both randomized and observational data from
these trials show increased survival following coronary artery bypass
grafting (CABG) in patients with left main coronary artery stenosis,
triple-vessel disease, double-vessel disease, left ventricular (LV)
functional impairment, or LV aneurysm. The incidence of fatal, but not
nonfatal, myocardial infarction is reduced by CABG. Results in patients 65
years of age or older are similar to those in younger patients but are
influenced by associated disease. Gainful employment and risk factors are
uninfluenced by treatment. Symptoms of congestive heart failure were not
improved by CABG alone but were improved by LV aneurysmectomy when this was
performed.