The Influence of Medical and Surgical Therapy on Progression of Coronary Artery Disease - Insights From a Randomized Study

Abstract

Controversies of efficacy (McIntosh and Garcia 1978) arising since the introduction of myocardial revascularization using saphenous vein grafts by Favaloro (1968) in 1967 have, for the most part, been resolved (Frye and Frommer 1982). Most rational interpretations of longevity studies have indicated the efficacy of this surgery in prolongation of life (Gunnar et al. 1980). The question of the effect of bypass grafting on native coronary disease progression has not yet been definitively answered, however, in spite of the many studies reported to date (Aldridge and Trimble 1971; Bourassa et al. 1973, 1978; Malinow et al. 1973; Maurer et al. 1974; Frick et al. 1975; Itscoitz et al. 1975; Robert et al. 1978; Levine et al. 1975; Glassman et al. 1974; Griffith et al. 1973; Benchimol et al. 1974; Gensini et al. 1974), and the influence of risk factors on this progression needs further study. The major shortcomings of previous studies have been that they were not prospective and that they lacked appropriately matched medically treated patients as a control group.