Survival of Coronary Artery Disease Patients with Stable Pain and Normal Left Ventricular Function Treated Medically or Surgically at Duke University

WHALEN, ROBERT E. M.D.
HARRELL, FRANK E. JR. PH.D.
LEE, KERRY L. PH.D.
RoSATI, ROBERT A. M.D.

From the Division of Cardiology and the Departments of Medicine and Community and Family Medicine, Duke University Medical Center, Durham, North Carolina.

Address for correspondence: Robert E. Whalen, M.D., Box 3393, Duke University Medical Center, Durham, North Carolina 27710.

Supported by contract HRA 230-76-0300 and research grant HS- 03834 from the National Center for Health Services Research and the National Center for Health Care Technology; research grant HL-17670 from the NHLBI; training grant LM-07003 and grants LM-03373 and LM-00042 from the National Library of Medicine; and by grants from the Prudential Insurance Company of America, the Kaiser Family Foundation and the Andrew W. Mellon Foundation.

Circulation 65:p II-52, June 1982.

SUMMARY

We evaluated the survival rates of medically and surgically treated patients with one-, two- or three-vessel coronary artery disease (CAD), stable pain, and normal left ventricular function observed at the Duke University Medical Center over an 11-year period. There was no statistical difference in survival when medical and surgical treatment were compared in patients with one-, two- or three-vessel disease (.2 75% vessel occlusion). However, the survival curve of patients with three-vessel disease treated surgically consistently exceeded that of those treated medically over a 7-year follow-up period. This difference was not statistically significant, but suggests the need for further study in this group.

When patients with 50% or greater lesions in three vessels, stable angina and normal left ventricular function were evaluated, surgical survival was greater than medical survival, although the difference is not statistically significant. The survival in the Duke medical group is substantially higher than that reported for medical patients in the European Cooperative Trial, which suggests that the significant differences in surgical survival in the European Cooperative Trial were largely due to a lower medical survival than that in the Duke medical group.