Long-term results of myocardial revascularization in early-onset arteriosclerosis.

The risk factors, anatomic disease states, and surgical results were compared between patients, who had coronary bypass operations before 40 years of age and patients who underwent bypass after 40. Elevated serum cholesterol levels were significantly more frequent in the younger group (P = 0.00704). However, these patients were a minority (12.6%) of the younger group the influence of elevated cholesterol levels on the subsequent course of the disease was minimal. The extent and location of coronary lesions and the states of ventricular function by ventriculograms were similar in the two groups. The surgical results were better in the younger group, but not to a significant degree. There were no operative deaths in the younger group and only two patients had perioperative myocardial infarctions. There is no justification for concern that the clinical course in early-onset coronary disease is accelerated. Also, the younger coronary disease patients are effectively treated by coronary artery bypass.