Is return of angina after coronary artery bypass grafting immutable, can it be delayed, and is it important? P. Sergeant, MD, E. Blackstone, MD*, B.

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Presentation transcript:

Is return of angina after coronary artery bypass grafting immutable, can it be delayed, and is it important? P. Sergeant, MD, E. Blackstone, MD*, B. Meyns, MD The Journal of Thoracic and Cardiovascular Surgery Volume 116, Issue 3, Pages 440-453 (September 1998) DOI: 10.1016/S0022-5223(98)70010-8 Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 1 A, Parametric freedom from the return of angina, without death or infarct the same day, after primary isolated CABG (n = 9600). B, Hazard function for the return of angina, without death or infarct the same day, at any time after primary isolated CABG (n = 9600; instantaneous risk at every point in time after the operation). The Journal of Thoracic and Cardiovascular Surgery 1998 116, 440-453DOI: (10.1016/S0022-5223(98)70010-8) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 2 A, Actuarial freedom from angina after primary CABG, by presence or absence of arterial grafting (combined or not with nonarterial grafting). B, Actuarial freedom from angina after primary CABG, by 1 or more than 1 in situ thoracic artery (IMA) distal anastomoses. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 440-453DOI: (10.1016/S0022-5223(98)70010-8) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 3 Patient-specific prediction for a median patient (see Table II) validating the influence of the use of at least a single thoracic artery (IMA) anastomosis, preferably to the LAD, on the freedom from angina after CABG. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 440-453DOI: (10.1016/S0022-5223(98)70010-8) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 4 Patient-specific prediction for a median patient (see Table II) validating the influence of increasing the ratio of arterial to total anastomoses on the freedom from angina after CABG. A ratio of 0:3 means that no arterial distal anastomosis was constructed on a total of 3 distal anastomoses. A ratio of 3:3 means that 3 arterial distal anastomoses were constructed on a total of 3 distal anastomoses. Note that the horizontal time axis is limited to the first 12 months. The Journal of Thoracic and Cardiovascular Surgery 1998 116, 440-453DOI: (10.1016/S0022-5223(98)70010-8) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 5 A, The actuarial and superimposed parametric survival function after the first return of angina after CABG (time 0, the moment of return of angina). B, Actuarial survival function (uncorrected for patient-variability) after the first return of angina after CABG (time 0, the moment of return of angina), stratified by patients with a single ITA (IMA) anastomosis versus patients with more than a single ITA anastomosis. C, The actuarial survival function (uncorrected for patient variability) after the first return of angina after CABG (time 0, the moment of return of angina) stratified by the grade of angina at first return of angina (see Table III). The Journal of Thoracic and Cardiovascular Surgery 1998 116, 440-453DOI: (10.1016/S0022-5223(98)70010-8) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 6 A, The actuarial and superimposed parametric freedom from infarct after the first return of angina after CABG (time 0, the moment of return of angina). B, The actuarial freedom from infarct (uncorrected for patient variability) after the first return of angina after CABG (time 0, the moment of return of angina), stratified by the presence of an arterial graft. C, The actuarial freedom rate from infarct (uncorrected for patient variability) after the first return of angina after CABG (time 0, the moment of return of angina) stratified by the grade of angina at the first return of angina (see Table III). The Journal of Thoracic and Cardiovascular Surgery 1998 116, 440-453DOI: (10.1016/S0022-5223(98)70010-8) Copyright © 1998 Mosby, Inc. Terms and Conditions

Fig. 7 The actuarial and superimposed parametric freedom rates from any cardiologic or cardiosurgical reintervention (time 0, the moment of first return of angina). The Journal of Thoracic and Cardiovascular Surgery 1998 116, 440-453DOI: (10.1016/S0022-5223(98)70010-8) Copyright © 1998 Mosby, Inc. Terms and Conditions