TY - JOUR
T1 - Late exercise test results from a prospective randomized study of bypass surgery for stable angina
AU - Pantely, G. A.
AU - Kloster, F. E.
AU - Morris, C. D.
PY - 1983
Y1 - 1983
N2 - A prospective randomized study comparing coronary bypass surgery (group 1, 51 patients) to drug therapy (group 2, 49 patients) was initiated in 1981. Supine graded exercise testing (SGXT) was performed initially, at 6 months, and annually with a bicycle ergometer. The presence or absence of ischemic ST segment changes (positive or negative SGXT) and chest pain were recorded. Initially, 63% of all patients had positive SGXT. For group 2, the frequency of positive SGXT results did not change significantly at 6 months (58%) or at 5 years (52%). At 6 months the number of patients without chest pain increased in group 1 compared with group 2 (28/41 vs 13/41, respectively; p < .002), but there was no difference in the frequency of positive SGXT results (20/41 vs 24/41, respectively; p = NS). This occurred because a majority of the group 1 patients with positive SGXT no longer had associated chest pain (group 1, 11/20, group 2, 3/24; p < .007). This response was associated with incomplete revascularization in eight of these 11 group 1 patients and may result from 'silent ischemia'. At 5 years, no significant difference existed in the incidence of positive SGXT (group 1, 10/32 vs group 2, 12/23; p = NS), but group 1 patients continued to have a reduction (although not statistically significant) in the number of patients without chest pain (group 1, 19/32 vs group 2, 7/23). The incidence of death and myocardial infarction were not significantly different between groups. Fewer episodes of unstable angina occurred in group 1 (10/51 vs 19/49; p < .05). The prognosis of group 1 patients with positive SGXT and no chest pain and incomplete revascularization was not different from that of the entire group.
AB - A prospective randomized study comparing coronary bypass surgery (group 1, 51 patients) to drug therapy (group 2, 49 patients) was initiated in 1981. Supine graded exercise testing (SGXT) was performed initially, at 6 months, and annually with a bicycle ergometer. The presence or absence of ischemic ST segment changes (positive or negative SGXT) and chest pain were recorded. Initially, 63% of all patients had positive SGXT. For group 2, the frequency of positive SGXT results did not change significantly at 6 months (58%) or at 5 years (52%). At 6 months the number of patients without chest pain increased in group 1 compared with group 2 (28/41 vs 13/41, respectively; p < .002), but there was no difference in the frequency of positive SGXT results (20/41 vs 24/41, respectively; p = NS). This occurred because a majority of the group 1 patients with positive SGXT no longer had associated chest pain (group 1, 11/20, group 2, 3/24; p < .007). This response was associated with incomplete revascularization in eight of these 11 group 1 patients and may result from 'silent ischemia'. At 5 years, no significant difference existed in the incidence of positive SGXT (group 1, 10/32 vs group 2, 12/23; p = NS), but group 1 patients continued to have a reduction (although not statistically significant) in the number of patients without chest pain (group 1, 19/32 vs group 2, 7/23). The incidence of death and myocardial infarction were not significantly different between groups. Fewer episodes of unstable angina occurred in group 1 (10/51 vs 19/49; p < .05). The prognosis of group 1 patients with positive SGXT and no chest pain and incomplete revascularization was not different from that of the entire group.
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U2 - 10.1161/01.CIR.68.2.413
DO - 10.1161/01.CIR.68.2.413
M3 - Article
C2 - 6345023
AN - SCOPUS:0020558407
SN - 0009-7322
VL - 68
SP - 413
EP - 419
JO - Circulation
JF - Circulation
IS - 2 I
ER -