Jonathan G Howlett1, Amanda Stebbins2, Mark C Petrie3, Pardeep S Jhund3, Serenella Castelvecchio4, Alexander Cherniavsky5, Carla A Sueta6, Ambuj Roy7, Ileana L Piña8, Raphael Wurm9, Mark H Drazner10, Bert Andersson11, Carmen Batlle12, Michele Senni13, Lukasz Chrzanowski14, Bela Merkely15, Peter Carson16, Patrice M Desvigne-Nickens17, Kerry L Lee2, Eric J Velazquez18, Hussein R Al-Khalidi2. 1. Libin Cardiovascular Institute and University of Calgary Medical Centre, Calgary, Canada. Electronic address: howlettjonathan@gmail.com. 2. Duke Clinical Research Institute and Department of Biostatistics and Bioinformatics, Durham, North Carolina. 3. British Heart Foundation Cardiovascular Research Centre, University of Glasgow, Glasgow, United Kingdom. 4. Istituto Di Ricovero e Cura a Carattere Scientifico Policlinico San Donato, San Donato Milanese, Milan, Italy. 5. E. Meshalkin National Medical Research Center of the Ministry of Health of the Russian Federation, Novosibirsk, Russia. 6. University of North Carolina School of Medicine, Chapel Hill, North Carolina. 7. All India Institute of Medical Sciences, New Delhi, India. 8. Albert Einstein College of Medicine, Montefiore Medical Center, New York City, New York. 9. Medical University of Vienna, Vienna, Austria. 10. University of Texas Southwestern Medical Center, Dallas, Texas. 11. Department of Cardiology, Sahlgrenska University Hospital, Goteborg, Sweden. 12. Centro de Investigación Cardiovascular Uruguayo Casa De Galicia, Montevideo, Uruguay. 13. Papa Giovanni XXIII Hospital, Bergamo, Italy. 14. Medical University of Lodz, Lodz, Poland. 15. Semmelweis University, Budapest, Budapest, Hungary. 16. Washington VA Medical Center, Washington, DC. 17. Division of Cardiovascular Sciences, National Institutes of Health, National Heart, Lung, and Blood Institute, Bethesda, Maryland. 18. Section of Cardiovascular Medicine, Department of Internal Medicine, Yale University School of Medicine, New Haven, Connecticut.
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 toCABG + 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).
RCT Entities:
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).
Authors: Bernard R Chaitman; Karen P Alexander; Derek D Cyr; Jeffrey S Berger; Harmony R Reynolds; Sripal Bangalore; William E Boden; Renato D Lopes; Marcin Demkow; Gian Piero Perna; Robert K Riezebos; Edward O McFalls; Subhash Banerjee; Akshay Bagai; Gilbert Gosselin; Sean M O'Brien; Frank W Rockhold; David D Waters; Kristian A Thygesen; Gregg W Stone; Harvey D White; David J Maron; Judith S Hochman Journal: Circulation Date: 2020-12-03 Impact factor: 29.690
Authors: Óscar M Peiró; Maria Ferrero; Alba Romeu; Anna Carrasquer; Gil Bonet; Mohsen Mohandes; Alberto Pernigotti; Alfredo Bardají Journal: J Clin Med Date: 2022-02-18 Impact factor: 4.241
Authors: Helga B Brynjarsdottir; Arni Johnsen; Alexandra A Heimisdottir; Sunna Rún Heidarsdottir; Anders Jeppsson; Martin I Sigurdsson; Tomas Gudbjartsson Journal: Interact Cardiovasc Thorac Surg Date: 2022-08-03