TY  - JOUR
AU  - Wrobel, Krzysztof
AU  - Stevens, Susanna R.
AU  - Jones, Robert H.
AU  - Selzman, Craig H.
AU  - Lamy, Andre
AU  - Beaver, Thomas M.
AU  - Djokovic, Ljubomir T.
AU  - Wang, Nan
AU  - Velazquez, Eric J.
AU  - Sopko, George
AU  - Kron, Irving L.
AU  - DiMaio, J. Michael
AU  - Michler, Robert E.
AU  - Lee, Kerry L.
AU  - Yii, Michael
AU  - Leng, Chua Yeow
AU  - Zembala, Marian
AU  - Rouleau, Jean L.
AU  - Daly, Richard C.
AU  - Al-Khalidi, Hussein R.
PY  - 2015
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/711
AB  - Background Patients with severe left ventricular dysfunction, ischemic heart failure, and coronary artery disease suitable for coronary artery bypass grafting (CABG) are at higher risk for surgical morbidity and mortality. Paradoxically, those patients with the most severe coronary artery disease and ventricular dysfunction who derive the greatest clinical benefit from CABG are also at the greatest operative risk, which makes decision making regarding whether to proceed to surgery difficult in such patients. To better inform such decision making, we analyzed the Surgical Treatment for Ischemic Heart Failure (STICH) CABG population for detailed information on perioperative risk and outcomes. Methods and Results In both STICH trials (hypotheses), 2136 patients with a left ventricular ejection fraction of 35% and coronary artery disease were allocated to medical therapy, CABG plus medical therapy, or CABG with surgical ventricular reconstruction. Relationships of baseline characteristics and operative conduct with morbidity and mortality at 30 days were evaluated. There were a total of 1460 patients randomized to and receiving surgery, and 346 (approximate to 25%) of these high-risk patients developed a severe complication within 30 days. Worsening renal insufficiency, cardiac arrest with cardiopulmonary resuscitation, and ventricular arrhythmias were the most frequent complications and those most commonly associated with death. Mortality at 30 days was 5.1% and was generally preceded by a serious complication (65 of 74 deaths). Left ventricular size, renal dysfunction, advanced age, and atrial fibrillation/flutter were significant preoperative predictors of mortality within 30 days. Cardiopulmonary bypass time was the only independent surgical variable predictive of 30-day mortality. Conclusions CABG can be performed with relatively low 30-day mortality in patients with left ventricular dysfunction. Serious postoperative complications occurred in nearly 1 in 4 patients and were associated with mortality. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00023595.
T2  - Circulation
T1  - Influence of Baseline Characteristics, Operative Conduct, and Postoperative Course on 30-Day Outcomes of Coronary Artery Bypass Grafting Among Patients With Left Ventricular Dysfunction Results From the Surgical Treatment for Ischemic Heart Failure (STICH) Trial
VL  - 132
IS  - 8
SP  - 720
EP  - 730
DO  - 10.1161/CIRCULATIONAHA.114.014932
ER  - 

@article{
author = "Wrobel, Krzysztof and Stevens, Susanna R. and Jones, Robert H. and Selzman, Craig H. and Lamy, Andre and Beaver, Thomas M. and Djokovic, Ljubomir T. and Wang, Nan and Velazquez, Eric J. and Sopko, George and Kron, Irving L. and DiMaio, J. Michael and Michler, Robert E. and Lee, Kerry L. and Yii, Michael and Leng, Chua Yeow and Zembala, Marian and Rouleau, Jean L. and Daly, Richard C. and Al-Khalidi, Hussein R.",
year = "2015",
abstract = "Background Patients with severe left ventricular dysfunction, ischemic heart failure, and coronary artery disease suitable for coronary artery bypass grafting (CABG) are at higher risk for surgical morbidity and mortality. Paradoxically, those patients with the most severe coronary artery disease and ventricular dysfunction who derive the greatest clinical benefit from CABG are also at the greatest operative risk, which makes decision making regarding whether to proceed to surgery difficult in such patients. To better inform such decision making, we analyzed the Surgical Treatment for Ischemic Heart Failure (STICH) CABG population for detailed information on perioperative risk and outcomes. Methods and Results In both STICH trials (hypotheses), 2136 patients with a left ventricular ejection fraction of 35% and coronary artery disease were allocated to medical therapy, CABG plus medical therapy, or CABG with surgical ventricular reconstruction. Relationships of baseline characteristics and operative conduct with morbidity and mortality at 30 days were evaluated. There were a total of 1460 patients randomized to and receiving surgery, and 346 (approximate to 25%) of these high-risk patients developed a severe complication within 30 days. Worsening renal insufficiency, cardiac arrest with cardiopulmonary resuscitation, and ventricular arrhythmias were the most frequent complications and those most commonly associated with death. Mortality at 30 days was 5.1% and was generally preceded by a serious complication (65 of 74 deaths). Left ventricular size, renal dysfunction, advanced age, and atrial fibrillation/flutter were significant preoperative predictors of mortality within 30 days. Cardiopulmonary bypass time was the only independent surgical variable predictive of 30-day mortality. Conclusions CABG can be performed with relatively low 30-day mortality in patients with left ventricular dysfunction. Serious postoperative complications occurred in nearly 1 in 4 patients and were associated with mortality. Clinical Trial Registration URL: http://www.clinicaltrials.gov. Unique identifier: NCT00023595.",
journal = "Circulation",
title = "Influence of Baseline Characteristics, Operative Conduct, and Postoperative Course on 30-Day Outcomes of Coronary Artery Bypass Grafting Among Patients With Left Ventricular Dysfunction Results From the Surgical Treatment for Ischemic Heart Failure (STICH) Trial",
volume = "132",
number = "8",
pages = "720-730",
doi = "10.1161/CIRCULATIONAHA.114.014932"
}

Wrobel, K., Stevens, S. R., Jones, R. H., Selzman, C. H., Lamy, A., Beaver, T. M., Djokovic, L. T., Wang, N., Velazquez, E. J., Sopko, G., Kron, I. L., DiMaio, J. M., Michler, R. E., Lee, K. L., Yii, M., Leng, C. Y., Zembala, M., Rouleau, J. L., Daly, R. C.,& Al-Khalidi, H. R.. (2015). Influence of Baseline Characteristics, Operative Conduct, and Postoperative Course on 30-Day Outcomes of Coronary Artery Bypass Grafting Among Patients With Left Ventricular Dysfunction Results From the Surgical Treatment for Ischemic Heart Failure (STICH) Trial. in Circulation, 132(8), 720-730.
https://doi.org/10.1161/CIRCULATIONAHA.114.014932

Wrobel K, Stevens SR, Jones RH, Selzman CH, Lamy A, Beaver TM, Djokovic LT, Wang N, Velazquez EJ, Sopko G, Kron IL, DiMaio JM, Michler RE, Lee KL, Yii M, Leng CY, Zembala M, Rouleau JL, Daly RC, Al-Khalidi HR. Influence of Baseline Characteristics, Operative Conduct, and Postoperative Course on 30-Day Outcomes of Coronary Artery Bypass Grafting Among Patients With Left Ventricular Dysfunction Results From the Surgical Treatment for Ischemic Heart Failure (STICH) Trial. in Circulation. 2015;132(8):720-730.
doi:10.1161/CIRCULATIONAHA.114.014932 .

Wrobel, Krzysztof, Stevens, Susanna R., Jones, Robert H., Selzman, Craig H., Lamy, Andre, Beaver, Thomas M., Djokovic, Ljubomir T., Wang, Nan, Velazquez, Eric J., Sopko, George, Kron, Irving L., DiMaio, J. Michael, Michler, Robert E., Lee, Kerry L., Yii, Michael, Leng, Chua Yeow, Zembala, Marian, Rouleau, Jean L., Daly, Richard C., Al-Khalidi, Hussein R., "Influence of Baseline Characteristics, Operative Conduct, and Postoperative Course on 30-Day Outcomes of Coronary Artery Bypass Grafting Among Patients With Left Ventricular Dysfunction Results From the Surgical Treatment for Ischemic Heart Failure (STICH) Trial" in Circulation, 132, no. 8 (2015):720-730,
https://doi.org/10.1161/CIRCULATIONAHA.114.014932 . .

TY  - JOUR
AU  - Velazquez, Eric J.
AU  - Lee, Kerry L.
AU  - Deja, Marek A.
AU  - Jain, Anil
AU  - Sopko, George
AU  - Marchenko, Andrey
AU  - Ali, Imtiaz S.
AU  - Pohost, Gerald
AU  - Gradinac, Sinisa
AU  - Abraham, William T.
AU  - Yii, Michael
AU  - Prabhakaran, Dorairaj
AU  - Szwed, Hanna
AU  - Ferrazzi, Paolo
AU  - Petrie, Mark C.
AU  - O'Connor, Christopher M.
AU  - Panchavinnin, Pradit
AU  - She, Lilin
AU  - Bonow, Robert O.
AU  - Rankin, Gena Roush
AU  - Jones, Robert H.
AU  - Rouleau, Jean-Lucien
AU  - STICH Investigators
PY  - 2011
UR  - https://vinar.vin.bg.ac.rs/handle/123456789/4287
AB  - 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 LT 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.
T2  - New England Journal of Medicine
T1  - Coronary-Artery Bypass Surgery in Patients with Left Ventricular Dysfunction
VL  - 364
IS  - 17
SP  - 1607
EP  - 1616
DO  - 10.1056/NEJMoa1100356
ER  - 

@article{
author = "Velazquez, Eric J. and Lee, Kerry L. and Deja, Marek A. and Jain, Anil and Sopko, George and Marchenko, Andrey and Ali, Imtiaz S. and Pohost, Gerald and Gradinac, Sinisa and Abraham, William T. and Yii, Michael and Prabhakaran, Dorairaj and Szwed, Hanna and Ferrazzi, Paolo and Petrie, Mark C. and O'Connor, Christopher M. and Panchavinnin, Pradit and She, Lilin and Bonow, Robert O. and Rankin, Gena Roush and Jones, Robert H. and Rouleau, Jean-Lucien and STICH Investigators",
year = "2011",
abstract = "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 LT 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.",
journal = "New England Journal of Medicine",
title = "Coronary-Artery Bypass Surgery in Patients with Left Ventricular Dysfunction",
volume = "364",
number = "17",
pages = "1607-1616",
doi = "10.1056/NEJMoa1100356"
}

Velazquez, E. J., Lee, K. L., Deja, M. A., Jain, A., Sopko, G., Marchenko, A., Ali, I. S., Pohost, G., Gradinac, S., Abraham, W. T., Yii, M., Prabhakaran, D., Szwed, H., Ferrazzi, P., Petrie, M. C., O'Connor, C. M., Panchavinnin, P., She, L., Bonow, R. O., Rankin, G. R., Jones, R. H., Rouleau, J.,& STICH Investigators. (2011). Coronary-Artery Bypass Surgery in Patients with Left Ventricular Dysfunction. in New England Journal of Medicine, 364(17), 1607-1616.
https://doi.org/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, STICH Investigators. Coronary-Artery Bypass Surgery in Patients with Left Ventricular Dysfunction. in New England Journal of Medicine. 2011;364(17):1607-1616.
doi:10.1056/NEJMoa1100356 .

Velazquez, Eric J., Lee, Kerry L., Deja, Marek A., Jain, Anil, Sopko, George, Marchenko, Andrey, Ali, Imtiaz S., Pohost, Gerald, Gradinac, Sinisa, Abraham, William T., Yii, Michael, Prabhakaran, Dorairaj, Szwed, Hanna, Ferrazzi, Paolo, Petrie, Mark C., O'Connor, Christopher M., Panchavinnin, Pradit, She, Lilin, Bonow, Robert O., Rankin, Gena Roush, Jones, Robert H., Rouleau, Jean-Lucien, STICH Investigators, "Coronary-Artery Bypass Surgery in Patients with Left Ventricular Dysfunction" in New England Journal of Medicine, 364, no. 17 (2011):1607-1616,
https://doi.org/10.1056/NEJMoa1100356 . .