Survival 15 to 20 years after coronary bypass surgery for angina

J Am Coll Cardiol. 1993 Jan;21(1):151-7. doi: 10.1016/0735-1097(93)90730-o.

Abstract

Objectives: The aim of this study was to determine the 15- to 20-year outcome of coronary bypass surgery in patients with angina.

Background: Coronary bypass surgery has been performed for > 20 years; we need to know the expected outcome of a very long-term follow-up.

Methods: Using actuarial techniques, we determined the outcome of coronary bypass surgery performed for chronic stable and unstable angina in 7,529 patients from 1969 to 1988.

Results: The 5-, 10-, 15- and 20-year survival rates (mean +/- SE) were 88 +/- 1, 73 +/- 1, 53 +/- 1 and 38 +/- 3%, respectively, for the whole group. Compared with patients operated on in 1974 to 1988 (n = 7,026), patients operated on in 1969 to 1973 (n = 503) were younger and had less coronary artery disease but had a higher operative mortality rate and a shorter long-term survival time; 15- and 20-year survival of the 1969 to 1973 cohort was 47 +/- 2% and 33 +/- 3%, respectively. The 1974 to 1988 cohort of patients had a 2.1% operative mortality rate and a 10- and 15-year survival probability of 74 +/- 1% and 55 +/- 2%, respectively. For 2,128 patients with "normal" left ventricular function, the 10- and 15-year survival probability was 82 +/- 1% and 64 +/- 3%, respectively, and for 2,413 patients with "abnormal" left ventricular function, it was 66 +/- 1% and 47 +/- 3%, respectively (p < 0.0001); for men it was 74 +/- 1% and 56 +/- 2%, respectively, and for women, 70 +/- 2% and 52 +/- 5%, respectively, p < 0.05. The actuarial percentages of reoperation and myocardial infarction at 15 years were 33 +/- 2% and 26 +/- 2%, respectively; these values did not differ significantly between men and women. There was a significant (p < 0.001) difference between men and women in angina status; 81% of the men versus 74% of the women had no angina or mild angina at the most recent follow-up study.

Conclusions: Coronary bypass surgery is an effective form of therapy for angina (for 15 to 20 years) in both men and women.

Publication types

  • Comparative Study

MeSH terms

  • Age Factors
  • Aged
  • Analysis of Variance
  • Angina Pectoris / mortality*
  • Angina Pectoris / surgery
  • Angina, Unstable / mortality*
  • Angina, Unstable / surgery
  • Chi-Square Distribution
  • Coronary Artery Bypass / mortality*
  • Coronary Artery Bypass / statistics & numerical data
  • Female
  • Follow-Up Studies
  • Humans
  • Life Tables
  • Male
  • Middle Aged
  • Oregon / epidemiology
  • Sex Factors
  • Surveys and Questionnaires
  • Survival Analysis
  • Technology Assessment, Biomedical*
  • Time Factors
  • Treatment Outcome*