Medical vs. urgent surgical therapy for acute coronary insufficiency: a randomized study.

Forty-two patients with acute coronary insufficiency (high risk subgroup) were randomly assigned to urgent coronary bypass surgery or to initial medical therapy followed by elective coronary bypass at four months if indicated at that time for relief of incapacitation angina pectoris. Coronary bypass performed on an urgent basis offered no advantage in preventing early myocardial infarction or death. The acute illness was resolved without permanent complications in most patients by either urgent bypass surgery or intensive medical therapy. The functional capacity at four months as assessed by objective testing was much greater in the urgent surgical group. Elective bypass surgery was carried out at that point in about half of the medical patients due to persistent incapacitating angina. Later serious complications have continued to occur in the medical patients but have not occurred up to the present time in the urgent surgical patients.

RCT Entities:   Population Interventions Outcomes