Long-term survival of patients with low ejection fraction: surgical versus medical management.

From May 1974 to December 1982, 3,592 patients underwent cardiac catheterization at the Buffalo Veterans' Administration Medical Center. Three hundred sixty-three patients (10.2%) presented with ejection fractions (EFs) < 40%. Of these, 194 had significant coronary artery disease. Follow-up data for retrospective analysis of survival rates were available for 173 of the 194 patients. Fifty-eight of these 173 had undergone coronary artery bypass surgery, while the remaining 115 had received medical treatment. The cumulative survival rates at 8 years for patients with EFs < 25% reveal a significantly better survival rate (61% vs. 29%, p <.03) for surgically treated patients. We conclude that coronary artery bypass surgery yields higher 8-year survival rates than does medical treatment for patients with compromised left ventricular function and significantly low EFs (< 25%).