CoChat
Sign Up
Cited by 1,001Lipoproteins and Cardiovascular HealthCardiac and Coronary Surgery TechniquesCholesterol and Lipid Metabolism

The DOI matches its Crossref record; 58 of the 58 references it cites were found in a registry or an index.

Effect of Partial Ileal Bypass Surgery on Mortality and Morbidity from Coronary Heart Disease in Patients with Hypercholesterolemia: Report of the Program on the Surgical Control of the Hyperlipidemias (POSCH)

Open access
Buchwald, Henry, Varco, Richard L., Matts, John P., Long, John M., Fitch, Laurie L., Campbell, Gilbert S., Pearce, Malcolm B., Yellin, Albert E., Edmiston, W. Allan, Smink, Robert D., Sawin, Henry S., Campos, Christian T., Hansen, Betty J., Tuna, Naip, Karnegis, James N., Sanmarco, Miguel E., Amplatz, Kurt, Castaneda-Zuniga, Wilfredo R., Hunter, David W., Bissett, Joseph K., Weber, Frederic J., Stevenson, James W., Leon, Arthur S., Chalmers, Thomas C.·1990·New England Journal of Medicine
DOI 10.1056/nejm199010043231404
Open this paper in CoChat — free accountOpen PDF

Abstract

BACKGROUND AND METHODS: The Program on the Surgical Control of the Hyperlipidemias (POSCH), a randomized clinical trial, was designed to test whether cholesterol lowering induced by the partial ileal bypass operation would favorably affect overall mortality or mortality due to coronary heart disease. The study population consisted of 838 patients (417 in the control group and 421 in the surgery group), both men (90.7 percent) and women, with an average age of 51 years, who had survived a first myocardial infarction. The mean follow-up period was 9.7 years. RESULTS: When compared with the control group at five years, the surgery group had a total plasma cholesterol level 23.3 percent lower (4.71 +/- 0.91 vs. 6.14 +/- 0.89 mmol per liter [mean +/- SD]; P less than 0.0001), a low-density lipoprotein cholesterol level 37.7 percent lower (2.68 +/- 0.78 vs. 4.30 +/- 0.89 mmol per liter; P less than 0.0001), and a high-density lipoprotein cholesterol level 4.3 percent higher (1.08 +/- 0.26 vs. 1.04 +/- 0.25 mmol per liter; P = 0.02). Overall mortality and mortality due to coronary heart disease were reduced, but not significantly so (deaths overall [control vs. surgery], 62 vs. 49, P = 0.164; deaths due to coronary disease, 44 vs. 32, P = 0.113). The overall mortality in the surgery subgroup with an ejection fraction greater than or equal to 50 percent was 36 percent lower (control vs. surgery, 39 vs. 24; P = 0.021). The value for two end points combined--death due to coronary heart disease and confirmed nonfatal myocardial infarction--was 35 percent lower in the surgery group (125 vs. 82 events; P less than 0.001). During follow-up, 137 control-group and 52 surgery-group patients underwent coronary-artery bypass grafting (P less than 0.0001). A comparison of base-line coronary arteriograms with those obtained at 3, 5, 7, and 10 years consistently showed less disease progression in the surgery group (P less than 0.001). The most common side effect of partial ileal bypass was diarrhea; others included occasional kidney stones, gallstones, and intestinal obstruction. CONCLUSIONS: Partial ileal bypass produces sustained improvement in the blood lipid patterns of patients who have had a myocardial infarction and reduces their subsequent morbidity due to coronary heart disease. The role of this procedure in the management of hypercholesterolemia remains to be determined. These results provide strong evidence supporting the beneficial effects of lipid modification in the reduction of atherosclerosis progression.

Overview

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Integrity signals

Registry

Crossref · 10.1056/nejm199010043231404

Cites

58 of 58 references verified0 citation errors · 0 not checkable

Statistics

Verification

Claims the paper makes

The claims and statistics of this paper haven’t been checked yet.

Run the check — free, no account needed. It reads the open-access text and checks the sources it cites.

A few free checks a day · papers already verified open instantly · results are public

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

The self-check needs the paper’s full text.

Citations

Cites

Show all 58 references

Research works printed but not linked: 29

  1. 10.1001/jama.256.20.2823 · DOI · Paper page
  2. Leren, 1966, Acta Med Scand Suppl, 466, 1
  3. 1968, Lancet, 2, 693
  4. Frantz, 1975, Circulation, 52, II-4
  5. 10.1001/jama.231.4.360 · DOI
  6. 10.1001/jama.251.3.351 · DOI · Paper page
  7. 10.1001/jama.257.23.3233 · DOI
  8. Buchwald H. Intestinal bypass for hypercholesterolemia. In: Nyhus LM, Baker RJ, eds. Mastery of surgery. Vol. 3. Boston: Little, Brown, 1984:901–7.
  9. Buchwald H, Campos CT. Partial ileal bypass for control of hyperlipidemia and atherosclerosis. In: Sabiston DC Jr, Spencer FC, eds. Surgery of the chest. 5th ed. Philadelphia: W.B. Saunders, 1990:1799–819.
  10. Schouten, 1986, Artery, 13, 240
  11. 1959, Stat Bull Metrop Life Insur Co, 40, 1
  12. Bruce, 1971, Ann Clin Res, 3, 323
  13. National Heart and Lung Institute, Lipid Research Clinics Program. Manual of laboratory operations. Vol. 1. Bethesda, Md.: National Institutes of Health, 1974. (DHEW publication no. (NIH) 75–628.)
  14. 1970, Bull World Health Organ, 43, 891
  15. Mantel, 1966, Cancer Chemother Rep, 50, 163
  16. Matts, Controlled Clin Trials
  17. Campos, 1987, Surgery, 102, 424
  18. Campos, 1988, Curr Surg, 45, 380
  19. Campos, 1988, Surg Forum, 39, 193
  20. Addison, 1851, Guys Hosp Rep, 2, 267
  21. Ignatovski, 1908, Izviest Imp Voyenno-med Akad S Petersb, 16, 154
  22. Anitschkow, 1913, Centralbl Allg Pathol Pathol Anat, 24, 1
  23. Wacker, 1913, Münchener Med Wochenschr, 60, 2097
  24. European Coronary Surgery Study Group, 1982, Lancet, 2, 1173
  25. Buchwald, 1965, Surgery, 58, 22
  26. Scott, 1967, Surg Gynecol Obstet, 125, 3
  27. Buchwald, 1963, Circulation, 28, II-649
  28. Moore, 1969, Surgery, 65, 98
  29. Buchwald, Ann Surg

Cited by

Sorted by citations

See all 1,001

Related

Metadata

Authors
Buchwald, H., Varco, R. L., Matts, J. P., Long, J. M., Fitch, L. L., Campbell, G. S., Pearce, M. B., Yellin, A. E., Edmiston, W. A., Smink, R. D., Sawin, H. S., Campos, C. T., Hansen, B. J., Tuna, N., Karnegis, J. N., Sanmarco, M. E., Amplatz, K., Castaneda-Zuniga, W. R., Hunter, D. W., Bissett, J. K., Weber, F. J., Stevenson, J. W., Leon, A. S., & Chalmers, T. C.
Affiliations
  • University of Minnesota (US)
  • University of Southern California (US)
ORCID
Venue
New England Journal of Medicine
Publisher
Massachusetts Medical Society
Published
1990-10-04
Volume
323
Issue
14
Pages
946-955
ISSN
  • 0028-4793 (ISSN-L)
  • 1533-4406
DOI
10.1056/nejm199010043231404
OpenAlex
W2331959986
Cited by
1,001
References
58
Citations by year
2026: 3 · 2025: 2 · 2024: 3 · 2023: 9 · 2022: 5 · 2021: 20 · 2020: 11 · 2019: 16 · 2018: 10 · 2017: 11 · 2016: 22 · 2015: 15 · 2014: 17 · 2013: 12 · 2012: 17
FWCI
84.71
Type
journal article
Language
en
Open access
Locations
  • New England Journal of Medicine (publishedVersion)
  • PubMed (publishedVersion)
Topics
  • Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Lipoproteins and Cardiovascular Health
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Biochemistry › Cholesterol and Lipid Metabolism
Keywords
partial ileal bypass, hypercholesterolemia, coronary artery disease, mortality, myocardial infarction, cholesterol lowering, LDL cholesterol, HDL cholesterol, first myocardial infarction, coronary artery bypass grafting, ejection fraction, long-term outcomes, nonfatal myocardial infarction
MeSH terms
Adult, Coronary Disease, Electrocardiography, Female, Follow-Up Studies, Humans, Hypercholesterolemia, Hyperlipidemias, Jejunoileal Bypass, Lipids, Male, Middle Aged, Ultrasonography, Multicenter Studies as Topic, Randomized Controlled Trials as Topic, Coronary Angiography

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

What counts as a claim ›How we measure confidence ›How we check this ›

Are you an author, or do you see a problem with this page? Request a review