[Survival of patients with triple-vessel stenosing coronary atheroma].

This study analysed the survival rate of 179 patients with triple vessel coronary artery disease, 168 men and 11 women (mean age 54 years). Seventeen cases of left main stem disease were excluded. The patients presented with unstable angina (64 cases), stable angina (66 cases), recent myocardial infarction (26 cases) or chronic invalidating angina (23 cases). Coronary bypass surgery was undertaken whenever possible (64 cases, 34% of patients). Medical therapy (115 cases) was based on betablockers (61%), amiodarone (22%) and perhexiline (17%). The study was carried out by a double questionnaire sent to the patient and treating physician, 6 months to 76 months after coronary angiography (average 30 months). The response to these questionnaires was 100%. Survival rates were calculated by actuarial methods. Comparisons of survival graphs was made using the Log Rang test. The overall survival rate was 89% at 1 year, 84% at 2 years, 82% at 5 years and 71% at 6 years. There seemed to be a lower mortality in the surgical group (p less than 0,28). The 2 year survival rate in the group with cardiac failure was 40% compared with 88% in the group without cardiac failure (p less than 0,001). There was no statistically significant difference in mortality except in patients with ejection fractions lower than 0,30. Analysis of survival with respect to mode of presentation did not show any significant difference between patients with unstable angina, stable angina or chronic invalidating angina. Mortality was higher when triple vessel disease was discovered during myocardial infarction, reaching 33% at 4 years, compared to 15% in the other subgroups (p less than 0,05).(ABSTRACT TRUNCATED AT 250 WORDS)