Factors to Prolong Survival in Patients with Coronary Artery Disease

Coronary artery bypass grafting generally relieves angina. Our stud­ies have shown that survival of these angina patients treated surgi­cally is superior at 3-5 years than in similar matched (but not ran­domized) patients treated medically. Factors associated with this im­proved survival are 1) low operative mortality; 0.9% in 757 patients for 1977, 1.5% for the total series, 2) a diminishing perioperative infarction rate, 1.6% for 1975, in light of evidence supporting an, association between perioperative infarction and late postoperative death, 3) a significant improvement in late survival of angina pa­tients with LV dysfunction operated on compared to those not oper­ated, 4) a similarity in survival among operated patients whether they have two- or three-vessel or left main disease. Other factors which are presumed to favorably influence postopera­tive survival are 1) complete revascularization, 2) improved intra­operative myocardial preservation, 3) late overall SVG patency rate (80%).