Japanese Heart Journal
Online ISSN : 1348-673X
Print ISSN : 0021-4868
ISSN-L : 0021-4868
Comparison of Long-term Efficacy of Medical Treatment versus Coronary Artery Bypass Grafting (CABG) in Multivessel Coronary Artery Disease
Shinichiro NISHIYAMA, Takashi IWASE, Sugao ISHIWATA, Nobuyuki KOMIYAMA, Toshiya KOBAYASHI, Yoshihiro NARUSE, Yoshiki YANAGISHITA, Haruo MAKUUCHI, Shigemoto NAKANISHI, Akira SEKI
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Keywords: Multi-vessel disease, Double-vessel disease, Triple-vessel disease, Long-term prognosis, Poor LV function, Medical treatment
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1995 Volume 36 Issue 6 Pages 709-717

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Abstract

The longterm results of medical therapy and coronary artery bypass grafting (CABG) were compared in patients with multivessel disease. All patients were confirmed to have≥75% luminal narrowing of major coronary arteries by coronary arteriogram. When multivessel disease was stratified into double and triple vessel disease, the outcomes varied. In triplevessel disease, the outcome with CABG was good, but the outcome was unfavorable in those employing medical therapy, particularly in patients with decreased left ventricular (LV) function. In patients with doublevessel disease with good LV function, the longterm results with medical therapy were just as favorable as those with CABG. However, doublevessel disease complicated by reduced LV function (ejection fraction≤40%) had a clearly less favorable outcome when treated with medical therapy than with CABG. Thus, it is important for patients with multivessel disease to undergo revascularization if indicated, to improve their prognosis. On the other hand, the incidence of cardiac events arising from vein graft occlusions tended to increase in CABG patients after 5 years or more following surgery.

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