Enhanced Late Survival Following Coronary Artery Bypass Graft Operation for Unstable versus Chronic Angina

Adnan Cobanoglu, Imanta Freimanis, Gary Grunkemeier, Louis Lambert, Vicki Anderson, David Nunley, Carlos Garcia, Albert Starr

Research output: Contribution to journalArticle

5 Citations (Scopus)

Abstract

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 < 0.001) and progressive (p < 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%. For those with poor LV function, the respective survival was 98.2%, 91%, and 88%. Late survival is not impaired by poor ventricular function in patients with unstable angina. This unexpected finding suggests greater reversibility in that subset.

Original languageEnglish (US)
Pages (from-to)52-59
Number of pages8
JournalAnnals of Thoracic Surgery
Volume37
Issue number1
DOIs
StatePublished - 1984

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Coronary Artery Bypass
Transplants
Survival
Left Ventricular Function
Unstable Angina
Ventricular Function

ASJC Scopus subject areas

  • Surgery
  • Pulmonary and Respiratory Medicine
  • Cardiology and Cardiovascular Medicine

Cite this

Cobanoglu, A., Freimanis, I., Grunkemeier, G., Lambert, L., Anderson, V., Nunley, D., ... Starr, A. (1984). Enhanced Late Survival Following Coronary Artery Bypass Graft Operation for Unstable versus Chronic Angina. Annals of Thoracic Surgery, 37(1), 52-59. https://doi.org/10.1016/S0003-4975(10)60710-2

Enhanced Late Survival Following Coronary Artery Bypass Graft Operation for Unstable versus Chronic Angina. / Cobanoglu, Adnan; Freimanis, Imanta; Grunkemeier, Gary; Lambert, Louis; Anderson, Vicki; Nunley, David; Garcia, Carlos; Starr, Albert.

In: Annals of Thoracic Surgery, Vol. 37, No. 1, 1984, p. 52-59.

Research output: Contribution to journalArticle

Cobanoglu, A, Freimanis, I, Grunkemeier, G, Lambert, L, Anderson, V, Nunley, D, Garcia, C & Starr, A 1984, 'Enhanced Late Survival Following Coronary Artery Bypass Graft Operation for Unstable versus Chronic Angina', Annals of Thoracic Surgery, vol. 37, no. 1, pp. 52-59. https://doi.org/10.1016/S0003-4975(10)60710-2
Cobanoglu, Adnan ; Freimanis, Imanta ; Grunkemeier, Gary ; Lambert, Louis ; Anderson, Vicki ; Nunley, David ; Garcia, Carlos ; Starr, Albert. / Enhanced Late Survival Following Coronary Artery Bypass Graft Operation for Unstable versus Chronic Angina. In: Annals of Thoracic Surgery. 1984 ; Vol. 37, No. 1. pp. 52-59.
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abstract = "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 < 0.001) and progressive (p < 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{\%}. For those with poor LV function, the respective survival was 98.2{\%}, 91{\%}, and 88{\%}. Late survival is not impaired by poor ventricular function in patients with unstable angina. This unexpected finding suggests greater reversibility in that subset.",
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