Surgical treatment for stable angina pectoris. Prospective randomized study.

Area of Science:

• Cardiology
• Cardiac Surgery
• Internal Medicine

Background:

• Stable angina significantly impacts patient quality of life.
• Coronary artery bypass grafting (CABG) is a major surgical intervention for coronary artery disease.

Purpose of the Study:

• To evaluate the efficacy of coronary artery bypass surgery versus medical management for stable angina.
• To compare symptom relief, exercise tolerance, cardiac complications, and mortality between surgical and medical groups.

Main Methods:

• Randomized controlled trial involving 72 patients with stable angina.
• Patients were allocated to either surgical (coronary bypass) or medical treatment groups.
• Follow-up included treadmill tests, repeat cardiac catheterization, and assessment of clinical outcomes over 28 months.

Main Results:

• 89% of surgically treated patients experienced symptom reduction versus 65% in the medical group; 69% became asymptomatic compared to 11% (p<0.01).
• Exercise tolerance improved more significantly in the surgical group (+78%) than the medical group (+48%) (p<0.05).
• Fewer cardiac complications occurred in the surgical group (14 vs. 34, p<0.02), with similar mortality rates (9% vs. 14%).

Conclusions:

• Coronary artery bypass surgery offers superior symptom relief and improved quality of life for stable angina patients compared to medical management within 28 months.
• While both treatments show benefits, surgery provides greater improvements in exercise capacity and reduces cardiac complications.
• The study highlights the significant role of surgical intervention in managing stable angina and enhancing patient well-being.