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Predicate | Object |
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rdf:type | |
lifeskim:mentions | |
pubmed:issue |
2 Pt 2
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pubmed:dateCreated |
1981-9-25
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pubmed:abstractText |
Stenosis of at least 50% of both the left anterior descending and circumflex coronary arteries proximal to their major branches has sometimes been called left main equivalent (LME) disease. During a 4-year interval, 189 LME patients were identified as surgical candidates by angiographic criteria. Coronary artery bypass grafting (CABG) was performed in 119 patients; 70 patients were managed nonoperatively. Treatment assignment was nonrandom. During the same interval, 203 patients with significant left main coronary artery (LMCA) stenosis and 742 patients with three-vessel disease without LMCA or LME stenosis underwent CABG. Follow-up is 99.2% complete at an average of 48 months (range 24--73 months). Operative mortality was significantly higher among LMCA patients (4.0%) than among LME surgical patients (0.8%) (p less than 0.05). Cumulative 5-year survival was better among LME surgical patients (98.2 +/- 1.3%) than among LME medical patients (75.9 +/- 5.7%) (p less than 0.0001) or LMCA surgical patients (92.8 +/- 2.1%) (p less than 0.03). All operative patient groups had a significantly lower incidence of myocardial infarction (10.3--13.4%) than the LME medical patients (25.7%) (p less than 0.05). Relief of angina was also significantly better in the operative groups (61--67.6%) than in LME medical patients (36%) (p less than 0.005). Major differences exist between LME and LMCA patients; LME is more properly considered a variant of multivessel coronary artery disease. Results of medical and surgical therapy suggest that patients with LME disease should be strongly considered for early operative therapy.
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pubmed:language |
eng
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pubmed:journal | |
pubmed:citationSubset |
AIM
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pubmed:status |
MEDLINE
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pubmed:month |
Aug
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pubmed:issn |
0009-7322
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pubmed:author | |
pubmed:issnType |
Print
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pubmed:volume |
64
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pubmed:owner |
NLM
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pubmed:authorsComplete |
Y
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pubmed:pagination |
II7-10
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pubmed:dateRevised |
2006-11-15
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pubmed:meshHeading |
pubmed-meshheading:7249331-Aged,
pubmed-meshheading:7249331-Angina Pectoris,
pubmed-meshheading:7249331-Coronary Angiography,
pubmed-meshheading:7249331-Coronary Disease,
pubmed-meshheading:7249331-Female,
pubmed-meshheading:7249331-Humans,
pubmed-meshheading:7249331-Male,
pubmed-meshheading:7249331-Middle Aged,
pubmed-meshheading:7249331-Myocardial Infarction
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pubmed:year |
1981
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pubmed:articleTitle |
Left main equivalent: results of medical and surgical therapy.
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pubmed:publicationType |
Journal Article,
Comparative Study
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