Myocardial revascularization for unstable angina pectoris.

We reviewed 14 reports from 1978 to 1988 of 6,136 patients with unstable angina pectoris treated by coronary artery bypass grafting (CABG). The mean age was 56.8 years, and 23% were female. Mean operative mortality in the 14 reports was 3.7% (1.2-8.5%). The mean incidence of perioperative myocardial infarction was 9.9% (3.8-17%). The mean incidence of postoperative low cardiac output was 16% (8-35%). No risk factors for morbidity or mortality different from those observed in patients with chronic stable angina were identified. Clinical subgroups of the heterogeneous group of patients with unstable angina pectoris are associated with different prognoses and treatment results. Variable pathological changes are associated with these subgroups. Reductions in morbidity and mortality of those patients undergoing CABG may require better preoperative management of the underlying pathological process and improved myocardial preservation at the time of CABG. Angina relief, improved survival, and reduction in late nonfatal myocardial infarction is similar to that observed in patients with chronic stable angina after CABG.