Related Experiment Video

Updated: Jul 21, 2026

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement
14:14

Standardized Technique of Aortic Valve Re-implantation for Valve-sparing Aortic Root Replacement

Published on: December 11, 2017

Progression of coronary artery disease in medically and surgically treated patients 5 years after randomization

R T Palac, M H Hwang, W R Meadows

    Circulation
    |August 1, 1981
    PubMed

    Insights

    Coronary artery disease progression at 5 years is similar for patients receiving medical or surgical treatment for chronic angina. Initial disease status significantly impacts progression risk, while grafted versus nongrafted vessels show comparable outcomes in surgical patients.

    Area of Science:

    • Cardiology
    • Interventional Cardiology
    • Vascular Biology

    Background:

    • Chronic angina affects numerous patients, necessitating effective long-term management strategies.
    • Understanding the progression of coronary artery disease (CAD) is crucial for optimizing treatment outcomes.
    • Medical and surgical interventions are primary treatment modalities for stable angina pectoris.

    Purpose of the Study:

    • To compare the progression of coronary artery disease at 5 years in patients with chronic angina treated medically versus surgically.
    • To evaluate the influence of initial disease status and graft patency on disease progression.

    Main Methods:

    • Repeat angiography was performed at approximately 65 months in medically and surgically treated patients.
    • Coronary arteries were analyzed by segments and major trunk vessels.
    • Disease progression was defined as new obstructions (>50%) or worsening of existing lesions.

    Main Results:

    • The incidence of disease progression was similar between medical (22% segments, 63% vessels) and surgical (23% segments, 63% vessels) groups.
    • Segments initially free of disease had a 14% progression rate, versus 37% in initially diseased segments (p<0.001).
    • In surgical patients, grafted (24%) and nongrafted (22%) segments showed similar progression; however, grafted vessels (70%) had higher progression than nongrafted vessels (51%) by major trunk analysis.

    Conclusions:

    • Five-year progression of coronary artery disease in stable angina is not influenced by randomization to medical or surgical therapy.
    • Vessels initially free of disease have a lower risk of developing new lesions within 5 years.
    • In surgically treated patients, grafted and nongrafted vessels demonstrate comparable rates of disease progression at the segment level.

    More Related Videos

    Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement08:50

    Technique and Patient Selection Criteria of Right Anterior Mini-Thoracotomy for Minimal Access Aortic Valve Replacement

    Published on: March 26, 2018

    Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis06:59

    Catheter-based Endovascular Angioplasty for Fibrosing Mediastinitis-associated Pulmonary Vein Stenosis

    Published on: August 26, 2025

    Related Concept Videos

    Aortic Regurgitation III: Medical Management01:25

    Aortic Regurgitation III: Medical Management

    Aortic regurgitation (AR) is when the aortic valve does not close or seal properly, leading to backward blood circulation from the aorta into the left ventricle during diastole. Common causes of AR include rheumatic heart disease, congenital valve defects, and aortic root dilation. Managing AR requires a multifaceted approach to alleviate symptoms, preserve left ventricular function, and address the underlying cause of the regurgitation. Patients with symptomatic AR or significant left...
    Coronary Artery Disease V: Interprofessional Care01:27

    Coronary Artery Disease V: Interprofessional Care

    Interprofessional care for coronary artery disease includes pharmacological therapy and revascularization procedures.Pharmacological therapy for Coronary Artery Disease (CAD) aims to manage symptoms, prevent complications, and improve patient outcomes through various classes of medications:Antiplatelet Agents:Aspirin and Clopidogrel: These medications inhibit platelet aggregation, preventing blood clots, which is crucial for avoiding heart attacks and strokes. Doctors often prescribe these...
    Cardiomyopathy II: Dilated Cardiomyopathy01:30

    Cardiomyopathy II: Dilated Cardiomyopathy

    Dilated cardiomyopathy, or DCM, is a progressive myocardial disorder characterized by ventricular chamber dilation and contractile dysfunction.EtiologyVarious factors can cause DCM, including hypertension and heavy alcohol intake, which contribute to the weakening and enlargement of the heart muscle. Viral infections, such as Coxsackievirus B, adenoviruses, and influenza, can lead to DCM by causing inflammation and damage to heart tissue. Certain chemotherapeutic agents, including daunorubicin,...
    Cardiomyopathy V: Interprofessional Care01:29

    Cardiomyopathy V: Interprofessional Care

    Managing cardiomyopathy involves addressing underlying or precipitating causes, treating heart failure with medications, and implementing dietary changes and a balanced exercise and rest regimen.Lifestyle ModificationsCardiomyopathy patients should adopt a low-sodium diet to reduce fluid retention and manage heart failure. A personalized exercise and rest plan helps maintain physical fitness without overstraining the heart. Avoiding alcohol and tobacco is essential to prevent further damage to...
    Peripheral Artery Disease III: Interprofessional Care01:27

    Peripheral Artery Disease III: Interprofessional Care

    Peripheral Artery Disease (PAD) is characterized by narrowed arteries that diminish blood flow to the extremities. Effective management of PAD requires an interprofessional approach involving various healthcare professionals. The critical aspects of interprofessional care for PAD patients focus on risk factor modification, drug therapy, exercise therapy, nutrition therapy, critical limb ischemia care, and interventional radiology and surgical procedures.The primary treatment goal for PAD...
    Peripheral Artery Disease V: Postoperative Nursing Management01:23

    Peripheral Artery Disease V: Postoperative Nursing Management

    During the postoperative period, it is crucial to focus on maintaining circulation, identifying and managing potential complications, and planning for discharge.Nursing AssessmentVital signs monitoring: Regularly monitor vital signs, including blood pressure, heart rate, respiratory rate, and temperature, to detect early signs of complications such as bleeding and infection.Circulation assessment: Monitor pulses, perform Doppler assessments, and check capillary refill, color, temperature, and...