Effects of coronary-artery bypass grafting on survival. Implications of the randomized coronary-artery surgery study.

IN 1977 the Journal published the results of the Veterans Administration randomized trial of coronary-artery bypass grafting (CABG).1 In an accompanying editorial2 I stated: "This report confirms the widely held impression that CABG reduces the incidence and severity of angina, but finds no difference in the survival of almost 600 patients with chronic stable angina (excluding those with obstructive disease of the left main coronary artery) randomized into medically and surgically treated groups. . . ." Concern was also expressed about the steeply rising frequency with which the procedure was being performed (approximately 70,000 in 1977) and that despite the . . .

[1]  L. Wilkins.  Coronary artery surgery study (CASS): a randomized trial of coronary artery bypass surgery. Quality of life in patients randomly assigned to treatment groups. , 1983, Circulation.

[2]  Lippincott Williams Wilkins,et al.  Coronary artery surgery study (CASS): a randomized trial of coronary artery bypass surgery. Survival data. , 1983, Circulation.

[3]  M. LeWinter,et al.  Protective effects of aspirin against acute myocardial infarction and death in men with unstable angina. Results of a Veterans Administration Cooperative Study. , 1983, The New England journal of medicine.

[4]  S. Kelsey,et al.  Percutaneous Transluminal Coronary Angioplasty: Report of Complications from the National Heart, Lung, and Blood Institute PTCA Registry , 1983, Circulation.

[5]  E. Braunwald,et al.  Mechanism of action of calcium-channel-blocking agents. , 1982, The New England journal of medicine.

[6]  M. Rubenfire,et al.  Randomized withdrawal from nifedipine: placebo-controlled study in patients with coronary artery spasm. , 1982, American heart journal.

[7]  I. Ringqvist,et al.  Effect of coronary bypass surgery on survival patterns in subsets of patients with left main coronary artery disease. Report of the Collaborative Study in Coronary Artery Surgery (CASS). , 1981, The American journal of cardiology.

[8]  P. Brandt,et al.  Coronary Surgery After Recurrent Myocardial Infarction: Progress of a Trial Comparing Surgical with Nonsurgical Management for Asymptomatic Patients with Advanced Coronary Disease , 1981, Circulation.

[9]  A. Hutter.  Is there a left main equivalent? , 1980, Circulation.

[10]  T. Takaro,et al.  Treatment of chronic stable angina. A preliminary report of survival data of the randomized Veterans Administration cooperative study. , 1977, The New England journal of medicine.

[11]  E. Braunwald,et al.  Coronary-artery surgery at the crossroads. , 1977, The New England journal of medicine.

[12]  L. T. Sheffield,et al.  Natural history of angina pectoris. , 1974, The American journal of cardiology.

[13]  Gibson Rs,et al.  Should exercise electrocardiographic testing be replaced by radioisotope methods , 1983 .