Coronary Angiography Quality Control in the CASS Study
The Coronary Artery Surgery Study (CASS) was organized in 1973 under the auspices of the National Heart, Lung, and Blood Institute. Enrollment of patients began in 1974 and continued through May 1979. CASS consists of a prospective, randomized study to compare the results of medical and surgical treatment in a subset of patients with anatomically proven coronary artery disease, and in a registry of consecutive patients undergoing coronary arteriography in 15 clinical sites in the United States and Canada. At the end of the enrollment period, 24,959 patients were entered into the registry, of which 780 patients were randomized to medical or surgical therapy. Extensive clinical and angiographic data are gathered on each subject at entry and during prolonged follow-up for both randomized and registry patients (1). Patients entered the CASS study when coronary arteriography and left ventriculography were carried out at a participating institution in a patient who was suspected of having coronary heart disease. Patients with other forms of heart disease were not entered, but patients who showed minimal or normal coronary arteries were retained in the registry. Therefore, at the end of enrollment in CASS, about 25,000 patients with carefully defined coronary artery anatomy are available for numerous types of investigations. This extensive data bank represents the largest collection of detailed anatomic information of heart disease in the world. For purposes of this conference, we wish to describe the quality control processes which were developed for entering arteriographic information into the CASS data center and to describe some of the problems related to the performance and interpretation of coronary arteriograms.
KeywordsCoronary Artery Left Anterior Descend Right Coronary Artery Left Main Coronary Artery Coronary Arteriography
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