Publication:
Coronary-artery bypass surgery in patients with left ventricular dysfunction

4

Issued Date

2011-04-28

Resource Type

Article

ISSN

15334406
00284793

DOI

10.1056/NEJMoa1100356

Other identifier(s)

2-s2.0-79955494359

Rights

Mahidol University

Rights Holder(s)

SCOPUS

Bibliographic Citation

New England Journal of Medicine. Vol.364, No.17 (2011), 1607-1616

Suggested Citation

Eric J. Velazquez, Kerry L. Lee, Marek A. Deja, Anil Jain, George Sopko, Andrey Marchenko, Imtiaz S. Ali, Gerald Pohost, Sinisa Gradinac, William T. Abraham, Michael Yii, Dorairaj Prabhakaran, Hanna Szwed, Paolo Ferrazzi, Mark C. Petrie, Christopher M. O'Connor, Pradit Panchavinnin, Lilin She, Robert O. Bonow, Gena Roush Rankin, Robert H. Jones, Jean Lucien Rouleau Coronary-artery bypass surgery in patients with left ventricular dysfunction. New England Journal of Medicine. Vol.364, No.17 (2011), 1607-1616. doi:10.1056/NEJMoa1100356 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/12534

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Title

Coronary-artery bypass surgery in patients with left ventricular dysfunction

Author(s)

Eric J. Velazquez
 Kerry L. Lee
 Marek A. Deja
 Anil Jain
 George Sopko
 Andrey Marchenko
 Imtiaz S. Ali
 Gerald Pohost
 Sinisa Gradinac
 William T. Abraham
 Michael Yii
 Dorairaj Prabhakaran
 Hanna Szwed
 Paolo Ferrazzi
 Mark C. Petrie
 Christopher M. O'Connor
 Pradit Panchavinnin
 Lilin She
 Robert O. Bonow
 Gena Roush Rankin
 Robert H. Jones
 Jean Lucien Rouleau

Other Contributor(s)

Duke University School of Medicine
 Duke Clinical Research Institute
 Slaski Uniwersytet Medyczny w Katowicach
 Instytut Kardiologii im. Prymasa Tysiaclecia Stefana Kardynala Wyszynskiego
 SAL Hospital and Medical Institute
 Center for Chronic Disease Control
 National Heart, Lung, and Blood Institute
 Novosibirsk Research Institute of Circulation Pathology Academician EN Meshalkina (NNIIPK)
 Dalhousie University
 Keck School of Medicine of USC
 University of Belgrade
 Ohio State University
 University of Melbourne
 Ospedali Riuniti Di Bergamo
 Golden Jubilee National Hospital
 Mahidol University
 Northwestern University
 Institut de Cardiologie de Montreal

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 < 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.) Copyright © 2011 Massachusetts Medical Society.

Keyword(s)

Medicine

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URI

https://repository.li.mahidol.ac.th/handle/123456789/12534

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Scopus 2011-2015