No Reduction in Mortality or Heart Attacks

The following thirty nine medical studies compare invasive treatment with conservative treatment of coronary artery disease.  Invasive treatment with bypass surgery or angioplasty is compared  with conservative treatment with drugs.   These Thirty Nine Studies show the failure of bypass surgery or angioplasty to reduce mortality or heart attacks when compared to conservative medical treatment with drugs.

Brain Damage from Cardiac Bypass

Three studies in 1000 patients found that 50% of patients having bypass surgery have brain damage with permanent loss of memory and mental function.

Economic Benefits Make it Popular

Invasive treatment with bypass and angioplasty may not be the best treatment, yet it is more popular than medical treatment because of the economic benefits.

Mortality Reduced in A limited Number of Cases

Coronary Bypass has been found to prolong life in the limited number of cases who have both left main coronary disease and reduced ejection fraction.  If Left Ventricluar function is normal, then bypass does not affect over all mortality compared to medical treatment.

Above information courtesy of Howard H. Wayne, M.D.  

Non-Q-wave Myocardial Infarction Following Thrombolytic Therapy

Percutaneous Transluminal Angioplasty Versus Medical Treatment For Non-Acute Coronary Heart Disease

An Invasive Strategy Reduced Death, Myocardial Infarction and Readmissions in Unstable Coronary Artery Disease

Intensive Medical Therapy Versus Coronary Angioplasty for Suppression of Myocardial Ischemia in Survivors of an Acute Myocardial Infarction

Outcome In Patients with Acute Non-Q Wave Myocardial Infarction Randomly Assigned to An Invasive As Compared with a Conservative Management Strategy

Twenty-two Year Follow-up in the VA Cooperative Study of Coronary artery bypass surgery for Stable Angina

A Prospective Randomized Trial of Triage Angiography in Acute Coronary Syndromes Ineligible for Trombolytic Therapy

Danish Multicenter Randomized Study of Invasive Versus Conservative Treatment In Patients With Inducible Ischemia After Thrombolysis In Acute Myocardial Infarction

Coronary Angioplasty Versus Medical Therapy For Angina

One Year Results of the Thrombolysis in Myocardial Infarction (TIMI)IIIB Clinical Trial

The Medicine, Angioplasty or Surgery Study (MASS)

The TIMI IIIB Investigators

Two and Three Year Results of the Thrombolysis in Myocardial Infarction (TIMI) Phase II Clinical Trial

Randomized Trial of Late Angioplasty Versus Conservative Management For Patients with Residual Stenosis After Thrombolytic Treatment of Myocardial Infarction

A Comparison of Angioplasty With Medical Therapy in the Treatment of Single Vessel Coronary Artery Disease

SWIFT Trial of Delayed Elective Intervention v. Conservative Treatment After Thrombolysis With Anistreplase in Acute Myocardial Infarction

Comparison of Immediate Invasive, Delayed Invasive and Conservative Strategies After Tissue-Type Plasminogen Activator

Randomized Controlled Trial of Late In-Hospital Angiography and Angioplasty Versus Conservative Management After Treatment With Recombinant Tissue-Type Plasminogen Activator in Acute Myocardial Infarction

Comparison of Invasive and Conservative Strategies After Treatment With Intravenous Tissue Plasminogen Activator in Acute Myocardial Infarction

Thrombolysis With Tissue Plasminogen Activator in Acute Myocardial Infarction: No Additional Benefit From Immediate Percutaneous Coronary Angioplasty

Comparison of Medical and Surgical Treatment for Unstable Angina Pectoris

Racial Differences in the Use of Invasive Cardiac Procedures and 1 Year Clinical Outcomes for Non-Q-Wave Myocardial Infarction Patients Randomized to Invasive vs. Conservative Management

A Comparison of the Impact of Practice Patterns on Outcome of Patients With Acute Coronary Syndromes in the USA and Canada: Post Hoc Analysis of ESSENCE and TIMI IIB

Outcome Study of Two Large Populations With Different Rates of Cardiac Interventions

Piegas, IS, Flather, M, Pogue J. et al. for the OASIS Registry Investigators

Comparison of Medical Care and Survival of Hospitalized Patients with Acute Myocardial Infarction in Poland and the United States

Use of Coronary Angiography and Revascularization Procedures Following Acute Myocardial Infarction: A European perspective

Use of Cardiac Procedures and Outcomes in Elderly Patients with Myocardial Infarction in the United States and Canada

Variation in the Use of Cardiac Procedures After Acute Myocardial Infarction

A Comparison of Management Patterns After Acute Myocardial Infarction in Canada and in the United States

Differences in the Treatment of Myocardial Infarction in the United States and Canada. A Comparison of Two University Hospitals

Comparison of Medical Care and One and 12 Month Mortality of Hospitalized patients with Acute Myocardial Infarction in Minneapolis-St. Paul, Minnesota, United States of America and Goteborg, Sweden

Longitudinal Assessment of Neurocognitive Function After Coronary Artery Bypass Surgery

Coronary Stenting or Percutaneous Transluminal Coronary Angioplasty Prior to Noncardiac Surgery Increases Adverse Events: The Evidence is Mounting

Catastrophic Outcomes of Noncardiac Surgery Soon After Coronary Stenting

Results of a Second-Opinion Trial Among Patients Recommended For Coronary Angiography

Two to Eight Year Survival Rates in Patients Who Refused Coronary Artery Bypass Grafting

Prognosis of Medically Treated Patients with Coronary Artery Disease With Profound ST-Segment Depression During Exercise Testing

Exercise Performance-Based Outcomes of Medically Treated Patients with Coronary Artery Disease and Profound ST Segment Depression

Jeffrey Dach MD (c) 2009 All rights reserved