Coronary artery bypass grafting has withstood the test of time, aspirin, HMG coreductase inhibitors and angioplasty. Three major randomized studies, the Coronary Artery Surgery Study (CASS), the Veterans Administration Cooperative Study Group (VA) and the European Coronary Surgery Study (ECSS), and four smaller randomized trials conducted between 1972 and 1984 provide the most reliable outcome data comparing medical and surgical therapy. A recent meta-analysis of seven randomized trials show that surgically treated patients at high risk (4.8 percent annual mortality) and moderate risk (2.5 percent annual mortality) experience clinically and statistically enhanced survival at 5, 7, and 10 years.

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