Natural history of obstructive coronary artery disease

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The results of a 10-year study of the natural history of obstructive coronary artery disease have been reported recently.1 Because of limitation of space, certain information obtained from the study was not included. The purpose of this supplement is to provide these data.


The material and methods have been reported in detail.1 Briefly, all 601 patients who had severely obstructive coronary artery disease demonstrated by arteriography when studied from January 1963 to July 1965 were followed a minimum of 10 years or until death. Patients who had undergone cardiac operations during the first 5 years had been excluded when the original study group was selected.1 In 1975 the findings at cardiac catheterization were reviewed and patients were classified relative to candidacy for bypass operation by recent criteria without regard to the other coded data. The 388 patients selected as those who would have been candidates for bypass operation if it had been available were studied as a subset of the original group.


Table 1 shows some of the characteristics of 31 patients who had bypass operations subsequent to selection and the interval between catheterization and operation. These patients were considered dropouts (“withdrawn alive”) from a statistical standpoint at the time of operation. Twenty-seven patients were alive at 120 months. The remaining four, all operated on elsewhere, died: two did not survive operation and two died of heart disease 2 and 3 months postoperatively. Fifteen (48%) had single-artery disease at the time of the first catheterization, compared to 29%. . .



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