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Indications for Surgical Treatment of Stable Angina Pectoris

Wilbert S. Aronow, MD
Arch Intern Med. 1979;139(6):690-692. doi:10.1001/archinte.1979.03630430066021.
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A ortocoronary bypass graft surgery (ACBGS) has been enthusiastically received by the medical profession. Many centers are advocating this operation to prolong life, to prevent myocardial infarction, to improve left ventricular function, and to improve the quality of life. However, except for prolonging life in patients with significant left main coronary artery disease and for improving the quality of life, the indications for this operation are not firmly agreed on. Until controlled clinical trials give us the data we need to formulate properly the indications for ACBGS, we must be cautious in recommending this operation.

NATURAL HISTORY DATA  Natural history studies indicate that the average annual mortality for patients with angina pectoris is approximately 4% to 5% per year. The mortality is higher in patients with angina pectoris who smoke or patients who have hypertension, a greater degree of ischemic ST-segment depression, a poor exercise duration on a treadmill until


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