RT Journal Article
SR 00
ID 10.1016/j.ijcard.2019.03.029
A1 Nicolau, Jose C.
A1 Stevens, Susanna R.
A1 Al-Khalidi, Hussein R.
A1 Jatene, Fabio B.
A1 Furtado, Remo H.M.
A1 Dallan, Luis A.O.
A1 Lisboa, Luiz A.F.
A1 Desvigne-Nickens, Patrice
A1 Haddad, Haissam
A1 Jolicoeur, E. Marc
A1 Petrie, Mark C.
A1 Doenst, Torsten
A1 Michler, Robert E.
A1 Ohman, E. Magnus
A1 Maddury, Jyotsna
A1 Ali, Imtiaz
A1 Deja, Marek A.
A1 Rouleau, Jean L.
A1 Velazquez, Eric J.
A1 Hill, James A.
T1 Does prior coronary angioplasty affect outcomes of surgical coronary revascularization? Insights from the STICH trial
JF International Journal of Cardiology
YR 2019
FD 2019-09-15
VO 291
SP 36
OP 41
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; Identifier: NCT00023595
NO This work was supported by the National Institutes of Health, National Heart, Lung, and Blood Institute grants U01 HL069015, U01 HL069013, and R01 HL105853.
PB Elsevier
SN 0167-5273
LK https://eprints.gla.ac.uk/182871/