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Coronary-artery bypass surgery in patients with left ventricular dysfunction.

Publication ,  Journal Article
Velazquez, EJ; Lee, KL; Deja, MA; Jain, A; Sopko, G; Marchenko, A; Ali, IS; Pohost, G; Gradinac, S; Abraham, WT; Yii, M; Prabhakaran, D ...
Published in: N Engl J Med
April 28, 2011

BACKGROUND: The role of coronary-artery bypass grafting (CABG) in the treatment of patients with coronary artery disease and heart failure has not been clearly established. METHODS: Between July 2002 and May 2007, a total of 1212 patients with an ejection fraction of 35% or less and coronary artery disease amenable to CABG were randomly assigned to medical therapy alone (602 patients) or medical therapy plus CABG (610 patients). The primary outcome was the rate of death from any cause. Major secondary outcomes included the rates of death from cardiovascular causes and of death from any cause or hospitalization for cardiovascular causes. RESULTS: The primary outcome occurred in 244 patients (41%) in the medical-therapy group and 218 (36%) in the CABG group (hazard ratio with CABG, 0.86; 95% confidence interval [CI], 0.72 to 1.04; P=0.12). A total of 201 patients (33%) in the medical-therapy group and 168 (28%) in the CABG group died from an adjudicated cardiovascular cause (hazard ratio with CABG, 0.81; 95% CI, 0.66 to 1.00; P=0.05). Death from any cause or hospitalization for cardiovascular causes occurred in 411 patients (68%) in the medical-therapy group and 351 (58%) in the CABG group (hazard ratio with CABG, 0.74; 95% CI, 0.64 to 0.85; P<0.001). By the end of the follow-up period (median, 56 months), 100 patients in the medical-therapy group (17%) underwent CABG, and 555 patients in the CABG group (91%) underwent CABG. CONCLUSIONS: In this randomized trial, there was no significant difference between medical therapy alone and medical therapy plus CABG with respect to the primary end point of death from any cause. Patients assigned to CABG, as compared with those assigned to medical therapy alone, had lower rates of death from cardiovascular causes and of death from any cause or hospitalization for cardiovascular causes. (Funded by the National Heart, Lung, and Blood Institute and Abbott Laboratories; STICH ClinicalTrials.gov number, NCT00023595.).

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Published In

N Engl J Med

DOI

EISSN

1533-4406

Publication Date

April 28, 2011

Volume

364

Issue

17

Start / End Page

1607 / 1616

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Proportional Hazards Models
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Intention to Treat Analysis
  • Humans
  • Hospitalization
  • Heart Failure
  • General & Internal Medicine
 

Citation

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Velazquez, E. J., Lee, K. L., Deja, M. A., Jain, A., Sopko, G., Marchenko, A., … STICH Investigators, . (2011). Coronary-artery bypass surgery in patients with left ventricular dysfunction. N Engl J Med, 364(17), 1607–1616. https://doi.org/10.1056/NEJMoa1100356
Velazquez, Eric J., Kerry L. Lee, Marek A. Deja, Anil Jain, George Sopko, Andrey Marchenko, Imtiaz S. Ali, et al. “Coronary-artery bypass surgery in patients with left ventricular dysfunction.N Engl J Med 364, no. 17 (April 28, 2011): 1607–16. https://doi.org/10.1056/NEJMoa1100356.
Velazquez EJ, Lee KL, Deja MA, Jain A, Sopko G, Marchenko A, et al. Coronary-artery bypass surgery in patients with left ventricular dysfunction. N Engl J Med. 2011 Apr 28;364(17):1607–16.
Velazquez, Eric J., et al. “Coronary-artery bypass surgery in patients with left ventricular dysfunction.N Engl J Med, vol. 364, no. 17, Apr. 2011, pp. 1607–16. Pubmed, doi:10.1056/NEJMoa1100356.
Velazquez EJ, Lee KL, Deja MA, Jain A, Sopko G, Marchenko A, Ali IS, Pohost G, Gradinac S, Abraham WT, Yii M, Prabhakaran D, Szwed H, Ferrazzi P, Petrie MC, O’Connor CM, Panchavinnin P, She L, Bonow RO, Rankin GR, Jones RH, Rouleau J-L, STICH Investigators. Coronary-artery bypass surgery in patients with left ventricular dysfunction. N Engl J Med. 2011 Apr 28;364(17):1607–1616.

Published In

N Engl J Med

DOI

EISSN

1533-4406

Publication Date

April 28, 2011

Volume

364

Issue

17

Start / End Page

1607 / 1616

Location

United States

Related Subject Headings

  • Ventricular Dysfunction, Left
  • Proportional Hazards Models
  • Middle Aged
  • Male
  • Kaplan-Meier Estimate
  • Intention to Treat Analysis
  • Humans
  • Hospitalization
  • Heart Failure
  • General & Internal Medicine