Unstable angina pectoris: National cooperative study group to compare surgical and medical therapy: II. In-Hospital experience and initial follow-up results in patients with one, two and three vessel disease

摘要: Abstract A prospective randomized study comparing intensive medical therapy with urgent coronary bypass surgery for the acute management of patients unstable angina pectoris was carried out by nine cooperating centers under auspices National Heart, Lung, and Blood Institute. Between 1972 1976, a total 288 were entered into study. All had transient S-T or T wave changes, both, in electrocardiogram during pain; 90 percent pain at rest hospital, 76 multivessel disease. The medically surgically treated comparable respect to clinical, electrocardiographic angiographic characteristics left ventricular function. During period, hospital mortality rate 5 surgical group 3 (difference not significant). in-hospital myocardial infarction 17 8 respective groups (P In 1st year after discharge class III IV (New York Heart Association criteria) more common than one vessel disease (22 versus percent, P results indicate that can be managed acutely therapy, including administration propranolol long-acting nitrates pharmacologic doses, adequate control most no increase early rates. Later, elective performed low risk good clinical if patient's fails respond therapy.