TY - JOUR
T1 - Does prior coronary angioplasty affect outcomes of surgical coronary revascularization? Insights from the STICH trial
AU - Nicolau, Jose C.
AU - Stevens, Susanna R.
AU - Al-Khalidi, Hussein R.
AU - Jatene, Fabio B.
AU - Furtado, Remo H.M.
AU - Dallan, Luis A.O.
AU - Lisboa, Luiz A.F.
AU - Desvigne-Nickens, Patrice
AU - Haddad, Haissam
AU - Jolicoeur, E. Marc
AU - Petrie, Mark C.
AU - Doenst, Torsten
AU - Michler, Robert E.
AU - Ohman, E. Magnus
AU - Maddury, Jyotsna
AU - Ali, Imtiaz
AU - Deja, Marek A.
AU - Rouleau, Jean L.
AU - Velazquez, Eric J.
AU - Hill, James A.
N1 - Funding Information:
Dr. Nicolau reports research grants (modest) from Amgen, Bayer, Bristol-Myers Squibb, DalCor, Janssen, Sanofi, AstraZeneca, Boehringer Ingelheim, Novartis, and Pfizer; and consulting/advisory board fees (modest) from Sanofi, Amgen, Vifor, and Servier, outside the submitted work. Dr. Furtado reports honoraria from AstraZeneca (modest) and grants (modest) from AstraZeneca, DalCor, Boehringer, Pfizer, Jansen and Sanofi, outside the submitted work. Dr. Velazquez reports research grants (significant) with Novartis, Amgen, National Heart, Lung, and Blood Institute, Pfizer and Alnylam and consultant/advisory board agreements (modest) with Novartis, Amgen, and Philips. Dr. Jolicoeur reports research grants (significant) from AstraZeneca, Boston Scientifics, and Philips, and consultant/advisory board agreements (modest) with Servier. All other co-authors have nothing to disclose.
Funding Information:
The authors thank Carlos José Dornas Gonçalves, MD for his suggestions on the analyses and Vanessa Moore for her editorial assistance with this manuscript. This work was supported by the National Institutes of Health, National Heart, Lung, and Blood Institute grants U01 HL069015, U01 HL069013, and R01 HL105853. This work is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or National Institutes of Health. Dr. Nicolau reports research grants (modest) from Amgen, Bayer, Bristol-Myers Squibb, DalCor, Janssen, Sanofi, AstraZeneca, Boehringer Ingelheim, Novartis, and Pfizer; and consulting/advisory board fees (modest) from Sanofi, Amgen, Vifor, and Servier, outside the submitted work. Dr. Furtado reports honoraria from AstraZeneca (modest) and grants (modest) from AstraZeneca, DalCor, Boehringer, Pfizer, Jansen and Sanofi, outside the submitted work. Dr. Velazquez reports research grants (significant) with Novartis, Amgen, National Heart, Lung, and Blood Institute, Pfizer and Alnylam and consultant/advisory board agreements (modest) with Novartis, Amgen, and Philips. Dr. Jolicoeur reports research grants (significant) from AstraZeneca, Boston Scientifics, and Philips, and consultant/advisory board agreements (modest) with Servier. All other co-authors have nothing to disclose. The authors report no relationships that could be construed as a conflict of interest.
Funding Information:
This work was supported by the National Institutes of Health , National Heart, Lung, and Blood Institute grants U01 HL069015 , U01 HL069013 , and R01 HL105853 . This work is solely the responsibility of the authors and does not necessarily represent the official views of the National Heart, Lung, and Blood Institute or National Institutes of Health.
Publisher Copyright:
© 2019 Elsevier B.V.
PY - 2019/9/15
Y1 - 2019/9/15
N2 - Background: The STICH trial showed superiority of coronary artery bypass plus medical treatment (CABG) over medical treatment alone (MED) in patients with left ventricular ejection fraction (LVEF) ≤35%. In previous publications, percutaneous coronary intervention (PCI) prior to CABG was associated with worse prognosis. Objectives: The main purpose of this study was to analyse if prior PCI influenced outcomes in STICH. Methods and results: Patients in the STICH trial (n = 1212), followed for a median time of 9.8 years, were included in the present analyses. In the total population, 156 had a prior PCI (74 and 82, respectively, in the MED and CABG groups). In those with vs. without prior PCI, the adjusted hazard-ratios (aHRs) were 0.92 (95% CI = 0.74–1.15) for all-cause mortality, 0.85 (95% CI = 0.64–1.11) for CV mortality, and 1.43 (95% CI = 1.15–1.77) for CV hospitalization. In the group randomized to CABG without prior PCI, the aHRs were 0.82 (95% CI = 0.70–0.95) for all-cause mortality, 0.75 (95% CI = 0.62–0.90) for CV mortality and 0.67 (95% CI = 0.56–0.80) for CV hospitalization. In the group randomized to CABG with prior PCI, the aHRs were 0.76 (95% CI = 0.50–1.15) for all-cause mortality, 0.81 (95% CI = 0.49–1.36) for CV mortality and 0.61 (95% CI = 0.41–0.90) for CV hospitalization. There was no evidence of interaction between randomized treatment and prior PCI for any endpoint (all adjusted p > 0.05). Conclusion: In the STICH trial, prior PCI did not affect the outcomes of patients whether they were treated medically or surgically, and the superiority of CABG over MED remained unchanged regardless of prior PCI. Clinical trial registration: Clinicaltrials.gov;
AB - Background: The STICH trial showed superiority of coronary artery bypass plus medical treatment (CABG) over medical treatment alone (MED) in patients with left ventricular ejection fraction (LVEF) ≤35%. In previous publications, percutaneous coronary intervention (PCI) prior to CABG was associated with worse prognosis. Objectives: The main purpose of this study was to analyse if prior PCI influenced outcomes in STICH. Methods and results: Patients in the STICH trial (n = 1212), followed for a median time of 9.8 years, were included in the present analyses. In the total population, 156 had a prior PCI (74 and 82, respectively, in the MED and CABG groups). In those with vs. without prior PCI, the adjusted hazard-ratios (aHRs) were 0.92 (95% CI = 0.74–1.15) for all-cause mortality, 0.85 (95% CI = 0.64–1.11) for CV mortality, and 1.43 (95% CI = 1.15–1.77) for CV hospitalization. In the group randomized to CABG without prior PCI, the aHRs were 0.82 (95% CI = 0.70–0.95) for all-cause mortality, 0.75 (95% CI = 0.62–0.90) for CV mortality and 0.67 (95% CI = 0.56–0.80) for CV hospitalization. In the group randomized to CABG with prior PCI, the aHRs were 0.76 (95% CI = 0.50–1.15) for all-cause mortality, 0.81 (95% CI = 0.49–1.36) for CV mortality and 0.61 (95% CI = 0.41–0.90) for CV hospitalization. There was no evidence of interaction between randomized treatment and prior PCI for any endpoint (all adjusted p > 0.05). Conclusion: In the STICH trial, prior PCI did not affect the outcomes of patients whether they were treated medically or surgically, and the superiority of CABG over MED remained unchanged regardless of prior PCI. Clinical trial registration: Clinicaltrials.gov;
KW - Coronary artery bypass surgery
KW - Heart failure
KW - Left ventricular dysfunction
KW - Percutaneous coronary intervention
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U2 - 10.1016/j.ijcard.2019.03.029
DO - 10.1016/j.ijcard.2019.03.029
M3 - Article
C2 - 30929973
AN - SCOPUS:85063513854
SN - 0167-5273
VL - 291
SP - 36
EP - 41
JO - International Journal of Cardiology
JF - International Journal of Cardiology
ER -