Life Expectancy in Angina Pectoris

Parker, Robert L.; Dry, Thomas J.; Willius, Fredrick A.; Gage, Robert P.

doi:10.1001/jama.1946.02870190019005

Cited by 47 publications

(7 citation statements)

References 6 publications

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“…Patients who had internal mammary artery implants within 5 In the patients who had internal mammary artery implants soon after arteriography, the results were difficult to evaluate. By subsequently determined standards of selection for operation many patients would not have been candidates for single implants because of the less than optimal degree of occlusion and the absence of collaterals, both determining factors of the success of the operation.…”

Section: Methodsmentioning

confidence: 99%

Selective Coronary Arteriography in Young Men A Follow-Up of 449 Patients

1974

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The prognosis for 449 young men with normal, mildly abnormal, and obstructive arteriograms with and without internal mammary artery implants was studied. Prognosis for patients with normal arteriograms was good in regard to incidence of infarction and mortality. In 30 patients with mildly abnormal arteriograms there appeared to be a relatively higher incidence of myocardial infarction, although the total number of patients in this category was small. with hypertension were included. The objective was to have at least a 5-year follow-up for each patient. Clinical records were examined and clinical data were coded for Hollerith cards without reference to catheterization findings. Analysis was done manually. The following classification was used:(1) normal: smooth vessels showing no variations in lumen diameter; (2) mildly abnormal: barely perceptible to less than 50% narrowing of lumen diameter; (3) obstructive: narrowing of lumen diameter between 50% and 100% with further subdivision to: (a) 50% to almost 90%; (b) 90% to almost 100%; (c) 100%. In the latter group more than one third of the patients (36%) had undergone myocardial revascularization. Follow-up information was obtained primarily from answers to questionnaires sent to the referring physicians. When information was not received, the patients were contacted. Relatives or employers of patients, credit bureaus, and the Bureau of Vital Statistics provided data otherwise unavailable. Information obtained included the incidence of morbidity (angina, myocardial infarction) and mortality (dates and causes of deaths).Survival curves of these patients were constructed by using actuarial methods.3 Date of catheterization was used as zero point in time. Definition of clinical diagnoses were those previously used.'Briefly stated, angina pectoris was considered to be distress somewhere in the upper half of the body which was precipitated by walking and relieved promptly (within 15 minutes) by rest. Myocardial infarction was diagnosed only on the basis of electrocardiographic demonstration of characteristically absent R waves or wide deep Q waves regardless of the presence or absence of a history suggestive of the condition.

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Section: Methodsmentioning

confidence: 99%

Selective Coronary Arteriography in Young Men A Follow-Up of 449 Patients

1974

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“…The clerical and computational work is greatly simplified if the estimate is based solely on the interval frequencies. Several such estimates have been suggested and used in application [1,2,3,4,8,9,13,16,18]. A discussion of their properties must be carried out within the framework of a model which includes, in addition to an assumption on, or an approximation to, pet) over the interval, information concerning the distribution of the 'I', for the withdrawals.…”

Section: The Sample Information Under the Common Closing Date Methodsmentioning

confidence: 99%

“…The estimate qJk of (5A) has been widely used [2,3,16,18] as an approximation to qL, which is the solution of the equation The survivorship function of (3A) corresponds to a decreasing intensity of risk rD(t) = --q --1 -q + qt and is an interesting addition to pet) =e-f.'t and pet) = 1-qt which have constant and increasing intensities respectively. For qL, and for D and L observations from a multinomial, the right hand side of (8A) may be taken [6, pp.…”

Section: Ql From Equation (4)mentioning

confidence: 99%

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Estimation of Survivorship in Chronic Disease: The “Actuarial” Method

Elveback

1958

Journal of the American Statistical Association

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“…The gravity of the prognosis of this disease has been emphasized by the disheartening reports of investigators who have followed large series of patients treated conservatively. Parker and his associates (1) reported only a 5-year survival in 3,440 cases with angina pectoris. The picture is even more disheartening in patients having suffered a myocardial infarction.…”

mentioning

confidence: 98%

Experimental Surgical Treatment of Occlusive Coronary Artery Disease

Bakst¹,

Boley²,

Morse³

et al. 1957

Angiology

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The inexorable increase in the mortality associated with occlusive coronary artery disease is alarming. The gravity of the prognosis of this disease has been emphasized by the disheartening reports of investigators who have followed large series of patients treated conservatively. Parker and his associates (1) reported only a 5-year survival in 3,440 cases with angina pectoris. The picture is even more disheartening in patients having suffered a myocardial infarction. Katz and his co-workers (2) reported 25 per cent of these people to be dead in 2 months, 50 per cent in 1 year, and 75 per cent in 3 years. Several surgical procedures have been utilized in a vigorous attempt to treat occlusive coronary artery disease. None, as yet, have been widely accepted because of the inherent danger entailed by surgery. However, further intensive investigation to find a way to revascularize the ischemic heart seems warranted.In previous work, cardiopericardiopexy produced by a talc granuloma protected the heart against ventricular fibrillation after a major coronary artery was ligated abruptly. This protection was due to a small quantity of blood brought to the heart by an increase in the extracoronary arterial collateral circulation through the pericardium. This fact stimulated a search for an even more vascular structure to which the left ventricular myocardium could be made adherent.This concept led to the development of a pedicled graft from the pectoralis major muscle. Granulomatous adhesions were produced between this pedicled muscle graft and the heart by instilling talcum powder between them. METHODS AND MATERIALSIn the cadaver, a pedicled pectoral muscle graft was brought to the heart. The pectoralis major was transected at its insertion into the humerus and a pedicle was formed of its lower third. Theoretically, the vascularity of this pedicle could be maintained by branches of the internal mammary artery entering it along its sternal attachments ( fig. 1). The fifth costal cartilage was removed, and the left thorax was entered through an anterior inframammary intercostal incision. The pericardium was opened longitudinally, anterior to the at UNIV OF MICHIGAN on July 13, 2015 ang.sagepub.com Downloaded from

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Life Expectancy in Angina Pectoris

Cited by 47 publications

References 6 publications

Selective Coronary Arteriography in Young Men A Follow-Up of 449 Patients

Selective Coronary Arteriography in Young Men A Follow-Up of 449 Patients

Estimation of Survivorship in Chronic Disease: The “Actuarial” Method

Experimental Surgical Treatment of Occlusive Coronary Artery Disease

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