Journal ArticleDOI
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)
Bernard R. Chaitman,Lloyd D. Fisher,Martial G. Bourassa,Kathryn Davis,William J. Rogers,Charles Maynard,Denis H. Tyras,Robert L. Berger,Melvin P. Judkins,Ivar Ringqvist,Michael B. Mock,Thomas Killip +11 more
Reads0
Chats0
TLDR
The data from this observational study show that coronary bypass surgery prolongs life in most patients with left main coronary artery disease, particularly those who have severe narrowing of the leftmain coronary artery or impaired left ventricular function.Abstract:
The 3 year cumulative survival rate of 1,492 patients with left main coronary artery disease (50 percent or greater stenosis of luminal diameter) enrolled in the Collaborative Study in Coronary Artery Surgery (CASS) was 91 percent for the surgical group and 69 percent for patients treated medically (p less than 0.0001). Mortality was significantly greater in patients with impaired left ventricular function. The difference between medical and surgical therapy was significant for patients who had normal, moderately abnormal and severely impaired left ventricular function and for patients with stenosis of the left main coronary artery of 50 to 59, 60 to 69, 70 to 79 and 80 percent or greater. Aortocoronary bypass surgery did not significantly improve survival in patient subgroups who had (1) a nonstenotic dominant right or balanced coronary circulation, (2) a stenotic dominant right coronary artery and normal left ventricular function, and (3) left main coronary stenosis of 50 to 59 percent and normal or mildly abnormal left ventricular function. The Cox proportional hazards model was used to select baseline variables that were independent predictors of long-time mortality. The model selected left ventricular score, age, congestive heart failure score, hypertension, percent left main coronary arterial stenosis and coronary arterial dominance as the baseline variables most predictive of long-term survival. A clinical and angiographic prognostic risk index developed from these six baseline variables showed significantly improved survival for the surgical cohort in each of four risk categories. In the best and worst risk category, the 3 year survival rate was 97 and 82 percent, respectively, for the surgical group and 85 and 34 percent, respectively, for the medical group (p less than or equal to 0.0002). The data from this observational study show that coronary bypass surgery prolongs life in most patients with left main coronary artery disease, particularly those who have severe narrowing of the left main coronary artery or impaired left ventricular function. The results permit a better understanding of the natural history of left main coronary artery disease and permit a more accurate estimate of long-term survival for individual patients through the use of a clinical-angiographic risk index.read more
Citations
More filters
Journal ArticleDOI
2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease
Rick A. Nishimura,Catherine M Otto,Robert O. Bonow,Blase A. Carabello,John P. Erwin,Robert A. Guyton,Patrick T. O'Gara,Carlos E. Ruiz,Nikolaos J. Skubas,Paul Sorajja,Thoralf M. Sundt,James D. Thomas +11 more
TL;DR: The medical profession should play a central role in evaluating evidence related to drugs, devices, and procedures for detection, management, and prevention of disease.
Journal ArticleDOI
2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention: A Report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines and the Society for Cardiovascular Angiography and Interventions
Glenn N. Levine,Eric R. Bates,James C. Blankenship,Steven R. Bailey,John A. Bittl,Bojan Cercek,Charles E. Chambers,Stephen G. Ellis,Robert A. Guyton,Steven M. Hollenberg,Umesh N. Khot,Richard A. Lange,Laura Mauri,Roxana Mehran,Issam Moussa,Debabrata Mukherjee,Brahmajee K. Nallamothu,Henry H. Ting,Alice K. Jacobs,Nancy M. Albert,Mark A. Creager,Steven M. Ettinger,Jonathan L. Halperin,Judith S. Hochman,Frederick G. Kushner,E. Magnus Ohman,William G. Stevenson,Clyde W. Yancy +27 more
TL;DR: Alice K. Jacobs, MD, FACC, FAHA, Chair Jeffrey L. Anderson, PhD, CCNS, CCRN, FAH, Chair-Elect - The first female FACC-FAHA board member to be elected in the history of the sport.
Journal ArticleDOI
2011 ACCF/AHA/SCAI Guideline for Percutaneous Coronary Intervention
Glenn N. Levine,Eric R. Bates,James C. Blankenship,Steven R. Bailey,John A. Bittl,Bojan Cercek,Charles E. Chambers,Stephen G. Ellis,Robert A. Guyton,Steven M. Hollenberg,Umesh N. Khot,Richard A. Lange,Laura Mauri,Roxana Mehran,Issam Moussa,Debabrata Mukherjee,Brahmajee K. Nallamothu,Henry H. Ting,Alice K. Jacobs,Jeffrey L. Anderson,Nancy M. Albert,Mark A. Creager,Steven M. Ettinger,Jonathan L. Halperin,Judith S. Hochman,Frederick G. Kushner,E. Magnus Ohman,William G. Stevenson,Clyde W. Yancy +28 more
TL;DR: The medical profession should play a central role in evaluating the evidence related to drugs, devices, and procedures for the detection, management, and prevention of disease as mentioned in this paper, and when properly applied, expert analysis of available data on the benefits and risks of these therapies and procedures can
Journal ArticleDOI
2014 AHA/ACC Guideline for the Management of Patients With Valvular Heart Disease A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines
Rick A. Nishimura,Catherine M Otto,Robert O. Bonow,Blase A. Carabello,John P. Erwin,Robert A. Guyton,Patrick T. O'Gara,Carlos E. Ruiz,Nikolaos J. Skubas,Paul Sorajja,Thoralf M. Sundt,James D. Thomas +11 more
TL;DR: In this paper, Anderson and Halperin proposed a new FAHA chair, named Jeffrey L. Anderson, MD, FACC, FAHA, Chair-Elect, Nancy M. Albert and Biykem Bozkurt.
Journal ArticleDOI
2014 ACC/AHA guideline on perioperative cardiovascular evaluation and management of patients undergoing noncardiac surgery: A report of the American college of cardiology/American heart association task force on practice guidelines
Lee A. Fleisher,Kirsten E. Fleischmann,Andrew D. Auerbach,Susan Barnason,Joshua A. Beckman,Biykem Bozkurt,Victor G. Davila-Roman,Marie Gerhard-Herman,Thomas A. Holly,Garvan C. Kane,Joseph E. Marine,M. Timothy Nelson,Crystal C. Spencer,Annemarie Thompson,Henry H. Ting,Barry F. Uretsky,Duminda N. Wijeysundera +16 more
TL;DR: The 2017-18 FACC/FAHA curriculum vitae will focus on adolescent and young adult FACC and FAHA education, as well as leadership, self-confidence, and self-consistency.
References
More filters
Journal ArticleDOI
The Statistical Analysis of Failure Time Data.
Journal ArticleDOI
The statistical analysis of failure time data
TL;DR: In this article, the authors proposed a regression model for failure time distributions in the context of counting process models and showed that the model can be used to estimate the probability of failure.
Journal Article
The VA cooperative randomized study of surgery for coronary arterial occlusive disease II. Subgroup with significant left main lesions.
TL;DR: The difference in the proportion of patients surviving after surgery as compared with medical treatment was greatest in patients with additional significant disease involving the right coronary artery, with or without left ventricular dysfunction.
Journal ArticleDOI
Angiographic prevalence of high-risk coronary artery disease in patient subsets (CASS)
Bernard R. Chaitman,Martial G. Bourassa,Kathryn Davis,William J. Rogers,Denis H. Tyras,Robert L. Berger,J W Kennedy,Lloyd D. Fisher,Melvin P. Judkins,Michael B. Mock,T Killip +10 more
TL;DR: High-risk coronary disease is common in middle-aged patients with definite angina and older patients with probable angina, but is rare in patients with nonspecific chest pain, according to evaluated results of the Coronary Artery Surgery Study from 1975-1979.