Unstable angina pectoris: A randomized study of patients treated medically and surgically

• Published in: The American journal of cardiology Vol. 41; no. 7; pp. 1291 - 1298
• Main Authors: Pugh, Billy, Platt, Melvin R., Mills, Lawrence J., Crumbo, Donald, Poliner, Lawrence R., Curry, George C., Blomqvist, Gunnar C., Parkey, Robert W., Buja, L.Maximilian, Willerson, James T.
• Format: Journal Article
• Language: English
• Published: United States Elsevier Inc 01.06.1978
• Subjects: Angina Pectoris - drug therapy; Angina Pectoris - mortality; Angina Pectoris - surgery; Cardiac Catheterization; Coronary Disease - drug therapy; Coronary Disease - mortality; Coronary Disease - surgery; Exercise Test; Female; Follow-Up Studies; Humans; Isosorbide Dinitrate - therapeutic use; Male; Middle Aged; Myocardial Revascularization; Propranolol - therapeutic use
• ISSN: 0002-9149; 1879-1913
• DOI: 10.1016/0002-9149(78)90888-3

Fifty patients with the clinical syndrome of unstable angina pectoris were evaluated. Twenty-seven were randomized into medical or surgical treatment groups and subsequently followed up. The results of the study reveal that: (1) there is approximately a 16 percent incidence rate of significant left main coronary artery disease in patients with this entity at our institution; (2) 10 percent of patients do not have angiographically significant coronary artery disease; (3) pain relief is better in the surgically treated patients, but the 1 1 2 year survival rate is not significantly different between the groups; (4) 50 percent of the medically treated patients again had the syndrome of unstable angina pectoris in the initial few months of the follow-up period; (5) the operative and late postoperative mortality rate in patients presenting with unstable angina pectoris and left main coronary artery disease in this small group of patients was 43 percent; and (6) four of six patients with this syndrome whose condition was deemed inoperable and who were not randomized died within the subsequent few months.