Unstable Angina Pectoris Trial

NCT ID: NCT00000486

Last Updated: 2013-11-26

Study Results

Results pending

The study team has not published outcome measurements, participant flow, or safety data for this trial yet. Check back later for updates.

Basic Information

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Recruitment Status

COMPLETED

Clinical Phase

PHASE3

Study Classification

INTERVENTIONAL

Study Start Date

1972-01-31

Study Completion Date

1980-01-31

Brief Summary

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To compare the efficacy of medical or surgical (coronary artery bypass graft) therapy with regard to survival and quality of life in patients with unstable angina and requisite coronary anatomy as defined by angiography.

Detailed Description

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BACKGROUND:

Angina pectoris is a symptomatic condition of attacks of chest pain, often debilitating. It is caused by a decreased supply of blood to the heart, such as that which might occur in coronary artery disease. The usual treatment of angina pectoris is designed to relieve the symptoms. It includes avoidance of activities that produce the discomfort and the use of nitroglycerin and beta blocking drugs. Soon after the introduction of coronary bypass surgery, many doctors enthusiastically adopted this approach in treating patients with unstable angina.

In 1972, emphasizing that there was no definitive evidence showing the superiority of intensive medical management or coronary bypass surgery in determining mortality and morbidity in patients hospitalized with unstable angina, some of the participating groups in the NHLBI Myocardial Infarction Research Units developed a cooperative clinical trial to compare these medical and surgical approaches to therapy.

From 1972 through 1976, 288 patients were entered into this randomized clinical trial. One hundred forty-seven patients received intensive pharmacological medical therapy, and 141 comparable patients underwent coronary artery bypass surgery. Careful follow-up studies were performed on patients in both groups, in-hospital and during the post-hospital phase. These studies included, apart from routine physical examinations, resting electrocardiograms, chest x-ray films, and grade exercise tolerance tests at six months and twelve months.

DESIGN NARRATIVE:

Randomized, non-blind, sequential design with a control group and an experimental group. The patients in the experimental group were treated with coronary bypass surgery. Patients in the control group received intensive medical management. Endpoints were mortality and morbidity measures, such as incidence of myocardial infarction and persistence of angina.

Conditions

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Angina, Unstable Cardiovascular Diseases Coronary Disease Heart Diseases Myocardial Ischemia

Study Design

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Allocation Method

RANDOMIZED

Primary Study Purpose

TREATMENT

Interventions

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coronary artery bypass

Intervention Type PROCEDURE

Eligibility Criteria

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Inclusion Criteria

Men and women, ages 21 to 65. Angina pectoris (class III or class IV) at rest or with minimal exercise.
Minimum Eligible Age

21 Years

Maximum Eligible Age

65 Years

Eligible Sex

ALL

Accepts Healthy Volunteers

No

Sponsors

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National Heart, Lung, and Blood Institute (NHLBI)

NIH

Sponsor Role lead

Principal Investigators

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Lewis Becker

Role:

Johns Hopkins University

Adolph Hutter

Role:

Massachusetts General Hospital

Leon Resnekov

Role:

University of Chicago

Richard Russell

Role:

University of Alabama at Birmingham

John Schroeder

Role:

Stanford University

Andrew Wallace

Role:

Duke University

References

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Unstable angina pectoris: national cooperative study group to compare medical and surgical therapy. I. Report of protocol and patient population. Am J Cardiol. 1976 May;37(6):896-902. doi: 10.1016/0002-9149(76)90116-8.

Reference Type BACKGROUND
PMID: 1266755 (View on PubMed)

Unstable angina pectoris: national cooperative study group to compare surgical and medical therapy. III. Results in patients with S-T segment elevation during pain. Am J Cardiol. 1980 Apr;45(4):819-24. doi: 10.1016/0002-9149(80)90127-7. No abstract available.

Reference Type BACKGROUND
PMID: 6965816 (View on PubMed)

Russell RO Jr, Wayne JB, Kronefeld J, Charles ED, Oberman A, Kouchoukos NT, White C, Rogers W, Mantle JA, Rackley CE. Surgical versus medical therapy for treatment of unstable angina: changes in work status and family income. Am J Cardiol. 1980 Jan;45(1):134-40. doi: 10.1016/0002-9149(80)90231-3. No abstract available.

Reference Type BACKGROUND
PMID: 6965333 (View on PubMed)

Other Identifiers

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5

Identifier Type: -

Identifier Source: org_study_id