"Coronary artery disease is a condition in which a waxy substance called plaque builds up inside the arteries which supply oxygenrich blood to your heart. Eventually an area of plaque can rupture and cause a blood clot to form on the plaques surface. If the blockage isnt treated quickly the portion of heart muscle fed by the artery begins to die. This heart damage may go unrecognized and lead to severe or longlasting problems. Coronary artery bypass grafting CABG is a surgical procedure that improves blood flow to the heart by bypassing clogged arteries. CABG was once thought to be too risky for patients with the longterm effects of coronary artery disease left ventricular dysfunction when the left side of the heart is unable to pump normally and heart failure when the heart cant pump enough blood to meet the bodys needs. Early studies of the safety and effectiveness of CABG excluded most patients with these conditions. The procedure was typically used to relieve disabling angina or chest pain. A team led by Dr. Eric J. Velazquez of Duke University Medical Center conducted a year randomized controlled trial to investigate the effects of CABG on patients with coronary artery disease that shows sign of left ventricular dysfunction and heart failure. More than  patients were included in the clinical trial. They were randomly assigned to receive either CABG plus medical treatment or medical treatment alone. The medical treatment included guidelinedirected medications and devices. Patients had followup evaluations every  months for the first year and then every subsequent  months. An extension study evaluated the year outcomes of the surgical intervention. Almost all the participants were included in the year followup results. The research was funded by NIHs National Heart Lung and Blood Institute NHLBI. Results were published online in the New England Journal of Medicine on April  . Death from any cause occurred in  patients  in the CABG group and in  patients  receiving medical treatment alone. A total of  patients  in the CABG group and  patients  in the medical treatment group died from cardiovascular causes. In addition the bypass surgery was associated with an overall .year increase in median survival time . vs. . years. These results show that CABG improves survival for people with coronary artery disease left ventricular dysfunction and heart failure. The current year followup provides new important insights about patient subgroups that are more likely to benefit from CABG as compared to medical therapy alone explains NHLBI Director Dr. Gary H. Gibbons. As such we now have a solid evidence base to inform patient care and the future development of clinical practice recommendations. Related Links  Who to Treat with Statins https  Fending Off Cardiovascular Disease https  Coronary Heart Disease http  Coronary Heart Disease Risk Factors http  Heart Disease in Women http  What is Heart Surgery http  Heart Failure http References CoronaryArtery Bypass Surgery in Patients with Ischemic Cardiomyopathy. https Velazquez EJ Lee KL Jones RH AlKhalidi HR Hill JA Panza JA Michler RE Bonow RO Doenst T Petrie MC Oh JK She L Moore VL DesvigneNickens P Sopko G Rouleau JL STICHES Investigators. N Engl J Med.  Apr . Epub ahead of print. PMID . Funding NIHs National Heart Lung and Blood Institute NHLBI."