Fifteen-year survival after coronary bypass surgery for unstable angina

We assessed the long-term results of coronary bypass surgery performed for unstable angina in 1743 patients from 1970 to 1987. The operative mortality was 1.8%. Using actuarial techniques, we determined that the 5-, 10-, and 15-year survival rates (mean±SE) were 89%±1%, 77%±2%, and 63%±3%, respectively, for the whole group. For patients with ''normal'' left ventricular function, they were 91%±1%, 83%±2%, and 71%±4%, and for patients with ''abnormal'' left ventricular function, 88%±2%, 70%±3%, and 55%±6% (P = 0.003). However, ''abnormal'' left ventricular function was associated with a significantly lower 15-year survival only in the subgroup of patients with disease in three or more vessels (48%±11% vs 71%±8% with ''normal'' left ventricular function; P = 0.007). The reoperation rates at 5, 10, and 15 years were 5%±0.6%, 17%±2%, and 34%±4%. Currently, 51% of the survivors have no angina; angina occurs on severe exertion in 27%, on ordinary exertion in 16%, and on mild exertion in 6%. We conclude that coronary bypass surgery is an effective form of therapy (for up to 15 years) in patients with unstable angina.