학술논문
CABG Improves Outcomes in Patients With Ischemic Cardiomyopathy: 10-Year Follow-Up of the STICH Trial.
Document Type
Academic Journal
Author
Howlett JG; Libin Cardiovascular Institute and University of Calgary Medical Centre, Calgary, Canada. Electronic address: howlettjonathan@gmail.com.; Stebbins A; Duke Clinical Research Institute and Department of Biostatistics and Bioinformatics, Durham, North Carolina.; Petrie MC; British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom.; Jhund PS; British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom.; Castelvecchio S; Istituto Di Ricovero e Cura a Carattere Scientifico Policlinico San Donato, San Donato Milanese, Milan, Italy.; Cherniavsky A; E. Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia.; Sueta CA; University of North Carolina School of Medicine, Chapel Hill, North Carolina.; Roy A; All India Institute of Medical Sciences, New Delhi, India.; Piña IL; Albert Einstein College of Medicine, Montefiore Medical Center, New York City, New York.; Wurm R; Medical University of Vienna, Vienna, Austria.; Drazner MH; University of Texas Southwestern Medical Center, Dallas, Texas.; Andersson B; Department of Cardiology, Sahlgrenska University Hospital, Goteborg, Sweden.; Batlle C; Centro de Investigación Cardiovascular Uruguayo Casa De Galicia, Montevideo, Uruguay.; Senni M; Papa Giovanni XXIII Hospital, Bergamo, Italy.; Chrzanowski L; Medical University of Lodz, Lodz, Poland.; Merkely B; Semmelweis University, Budapest, Budapest, Hungary.; Carson P; Washington VA Medical Center, Washington, DC.; Desvigne-Nickens PM; Division of Cardiovascular Sciences, National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, Maryland.; Lee KL; Duke Clinical Research Institute and Department of Biostatistics and Bioinformatics, Durham, North Carolina.; Velazquez EJ; Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.; Al-Khalidi HR; Duke Clinical Research Institute and Department of Biostatistics and Bioinformatics, Durham, North Carolina.
Source
Publisher: Elsevier Country of Publication: United States NLM ID: 101598241 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 2213-1787 (Electronic) Linking ISSN: 22131779 NLM ISO Abbreviation: JACC Heart Fail Subsets: MEDLINE
Subject
Language
English
Abstract
Objectives: The authors investigated the impact of coronary artery bypass grafting (CABG) on first and recurrent hospitalization in this population.
Background: In the STICH (Surgical Treatment for Ischemic Heart Failure) trial, CABG reduced all-cause death and hospitalization in patients with and ischemic cardiomyopathy and left ventricular ejection fraction <35%.
Methods: A total of 1,212 patients were randomized (610 to CABG + optimal medical therapy [CABG] and 602 to optimal medical therapy alone [MED] alone) and followed for a median of 9.8 years. All-cause and cause-specific hospitalizations were analyzed as time-to-first-event and as recurrent event analysis.
Results: Of the 1,212 patients, 757 died (62.4%) and 732 (60.4%) were hospitalized at least once, for a total of 2,549 total all-cause hospitalizations. Most hospitalizations (66.2%) were for cardiovascular causes, of which approximately one-half (907 or 52.9%) were for heart failure. More than 70% of all hospitalizations (1,817 or 71.3%) were recurrent events. The CABG group experienced fewer all-cause hospitalizations in the time-to-first-event (349 CABG vs. 383 MED, adjusted hazard ratio [HR]: 0.85; 95% confidence interval [CI]: 0.74 to 0.98; p = 0.03) and in recurrent event analyses (1,199 CABG vs. 1,350 MED, HR: 0.78, 95% CI: 0.65 to 0.94; p < 0.001). This was driven by fewer total cardiovascular (CV) hospitalizations (744 vs. 968; p < 0.001, adjusted HR: 0.66, 95% CI: 0.55 to 0.81; p = 0.001), the majority of which were due to HF (395 vs. 512; p < 0.001, adjusted HR: 0.68, 95% CI: 0.52-0.89; p = 0.005). We did not observe a difference in non-CV events.
Conclusions: CABG reduces all-cause, CV, and HF hospitalizations in time-to-first-event and recurrent event analyses. (Comparison of Surgical and Medical Treatment for Congestive Heart Failure and Coronary Artery Disease [STICH]; NCT00023595).
(Copyright © 2019 American College of Cardiology Foundation. All rights reserved.)
Background: In the STICH (Surgical Treatment for Ischemic Heart Failure) trial, CABG reduced all-cause death and hospitalization in patients with and ischemic cardiomyopathy and left ventricular ejection fraction <35%.
Methods: A total of 1,212 patients were randomized (610 to CABG + optimal medical therapy [CABG] and 602 to optimal medical therapy alone [MED] alone) and followed for a median of 9.8 years. All-cause and cause-specific hospitalizations were analyzed as time-to-first-event and as recurrent event analysis.
Results: Of the 1,212 patients, 757 died (62.4%) and 732 (60.4%) were hospitalized at least once, for a total of 2,549 total all-cause hospitalizations. Most hospitalizations (66.2%) were for cardiovascular causes, of which approximately one-half (907 or 52.9%) were for heart failure. More than 70% of all hospitalizations (1,817 or 71.3%) were recurrent events. The CABG group experienced fewer all-cause hospitalizations in the time-to-first-event (349 CABG vs. 383 MED, adjusted hazard ratio [HR]: 0.85; 95% confidence interval [CI]: 0.74 to 0.98; p = 0.03) and in recurrent event analyses (1,199 CABG vs. 1,350 MED, HR: 0.78, 95% CI: 0.65 to 0.94; p < 0.001). This was driven by fewer total cardiovascular (CV) hospitalizations (744 vs. 968; p < 0.001, adjusted HR: 0.66, 95% CI: 0.55 to 0.81; p = 0.001), the majority of which were due to HF (395 vs. 512; p < 0.001, adjusted HR: 0.68, 95% CI: 0.52-0.89; p = 0.005). We did not observe a difference in non-CV events.
Conclusions: CABG reduces all-cause, CV, and HF hospitalizations in time-to-first-event and recurrent event analyses. (Comparison of Surgical and Medical Treatment for Congestive Heart Failure and Coronary Artery Disease [STICH]; NCT00023595).
(Copyright © 2019 American College of Cardiology Foundation. All rights reserved.)