Treatment of Chronic Stable Angina

TLDR

The study evaluated whether saphenous‑vein‑bypass grafting improves survival compared to medical therapy in patients with chronic stable angina. In a large prospective randomized trial, 596 patients without left‑main disease were assigned to medical (310) or surgical (286) groups, with comparable baseline clinical and angiographic characteristics. Operative mortality was 5.6 % at 30 days, 69 % of grafts were patent at one year, and there was no significant survival difference at 21 months, with 87 % of the medical group and 88 % of the surgical group alive at 36 months.

Abstract

We evaluated the effect of saphenous-vein-bypass grafting on survival in patients with chronic stable angina by comparing medical and surgical treatment in a large-scale, prospective randomized study. Excluding patients with left-main-coronary-artery disease who have already been reported, a total of 596 patients were entered into this study; when randomized into a medical group (310 patients) and a surgical group (286 patients), entry clinical and angiographic base lines were comparable. Operative mortality at 30 days was 5.6 per cent. At an average of one year after operation, 69 per cent of all grafts were patent, and 88 per cent of the surgical patients had atleast one patent graft. There was no statistically significant difference in survival, at a minimal follow-up interval of 21 months, between patients treated medically and those treated with saphenous-vein-bypass grafting. At 36 months, 87 per cent of the medical group and 88 per cent of the surgical group were alive.