Detre K M, Peduzzi P, Hammermeister K E, Murphy M L, Hultgren H N, Takaro T
Am J Cardiol. 1984 Feb 1;53(4):444-50. doi: 10.1016/0002-9149(84)90010-9.
The effect of coronary artery bypass grafting (CABG) and medical therapy on 5-year resting left ventricular (LV) function was studied in 194 randomized patients with stable angina in the Veterans Administration Study of Coronary Artery Bypass Surgery. LV ejection fraction (EF) was determined in a central laboratory. The 92 medical and 102 surgical patients were comparable at entry with respect to historic, angiographic and electrocardiographic prognostic indicators. Twenty-eight percent of the medical and 30% of the surgical patients had a baseline EF of less than 50%. There was no significant change in mean EF between baseline and 5-year values in either treatment group. The baseline and 5-year values were 56 and 58% in each treatment group. Intervening myocardial infarction (MI) had an adverse effect in medically treated patients (59 to 46%, p less than 0.01) and in surgically treated patients with late MI (58 to 47%, difference not significant). Perioperative MI was not associated with a decrease in EF (56 to 58%, difference not significant). These findings extend the similar results of previous short-term studies of the effect of coronary bypass surgery on resting LV function to 5 years, and provide data in a comparable medical control group.
在退伍军人管理局冠状动脉搭桥手术研究中，对194例稳定型心绞痛随机患者进行了冠状动脉搭桥术（CABG）和药物治疗对5年静息左心室（LV）功能影响的研究。左心室射血分数（EF）在中心实验室测定。92例药物治疗患者和102例手术治疗患者在入组时的病史、血管造影和心电图预后指标方面具有可比性。28%的药物治疗患者和30%的手术治疗患者基线EF低于50%。两个治疗组的平均EF在基线和5年值之间均无显著变化。每个治疗组的基线值和5年值分别为56%和58%。发生介入性心肌梗死（MI）对药物治疗患者（从59%降至46%，p<0.01）以及发生晚期MI的手术治疗患者（从58%降至47%，差异不显著）有不良影响。围手术期MI与EF降低无关（从56%降至58%，差异不显著）。这些发现将先前关于冠状动脉搭桥手术对静息LV功能影响的短期研究的类似结果扩展至5年，并在具有可比性的药物对照组中提供了数据。
