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Related Experiment Videos

Exercise testing in the Coronary Artery Surgery Study randomized population.

T J Ryan, D A Weiner, C H McCabe

    Circulation
    |December 1, 1985
    PubMed
    Summary
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    Coronary Artery Surgery Study found no significant survival difference between surgical and medical treatments over 7 years. However, surgery offered a survival advantage for patients with exercise-induced angina.

    Area of Science:

    • Cardiology
    • Clinical Trials
    • Preventive Cardiology

    Background:

    • The Coronary Artery Surgery Study (CASS) randomized 780 patients to surgical or medical therapy.
    • Exercise electrocardiographic stress testing is a common diagnostic tool in cardiology.

    Purpose of the Study:

    • To evaluate the impact of exercise stress testing on 7-year survival in patients undergoing coronary artery surgery versus medical therapy.
    • To determine if exercise test parameters predict outcomes in the Coronary Artery Surgery Study.

    Main Methods:

    • 81% of randomized patients underwent exercise electrocardiographic stress testing at baseline.
    • Patients were stratified by ST segment depression and exercise stage (Bruce protocol).
    • 7-year survival rates were compared between surgical and medical groups, and within groups based on exercise test results.

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    Main Results:

    • Overall 7-year survival was 90% for surgical and 88% for medical groups (not significant).
    • No significant survival differences were found based on ST depression or exercise stage.
    • Patients with exercise-induced angina showed improved survival with surgical therapy (94% vs. 87%, p=0.007).

    Conclusions:

    • Exercise stress test results, including ST depression and exercise stage, did not significantly alter 7-year survival predictions in the Coronary Artery Surgery Study.
    • Surgical intervention demonstrated a survival benefit for patients experiencing exercise-induced angina.