Coronary-artery bypass surgery in patients with ischemic cardiomyopathy

Eric J. Velazquez, Kerry L. Lee, Robert H. Jones, Hussein R. Al-Khalidi, James A. Hill, Julio A. Panza, Robert E. Michler, Robert O. Bonow, Torsten Doenst, Mark C. Petrie, Jae K. Oh, Lilin She, Vanessa L. Moore, Patrice Desvigne-Nickens, George Sopko, Jean L. Rouleau

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Abstract

BACKGROUND The survival benefit of a strategy of coronary-artery bypass grafting (CABG) added to guideline-directed medical therapy, as compared with medical therapy alone, in patients with coronary artery disease, heart failure, and severe left ventricular systolic dysfunction remains unclear. METHODS From July 2002 to 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 undergo CABG plus medical therapy (CABG group, 610 patients) or medical therapy alone (medical-therapy group, 602 patients). The primary outcome was death from any cause. Major secondary outcomes included death from cardiovascular causes and death from any cause or hospitalization for cardiovascular causes. The median duration of follow-up, including the current extended-follow-up study, was 9.8 years. RESULTS A primary outcome event occurred in 359 patients (58.9%) in the CABG group and in 398 patients (66.1%) in the medical-therapy group (hazard ratio with CABG vs. medical therapy, 0.84; 95% confidence interval [CI], 0.73 to 0.97; P = 0.02 by log-rank test). A total of 247 patients (40.5%) in the CABG group and 297 patients (49.3%) in the medical-therapy group died from cardiovascular causes (hazard ratio, 0.79; 95% CI, 0.66 to 0.93; P = 0.006 by log-rank test). Death from any cause or hospitalization for cardiovascular causes occurred in 467 patients (76.6%) in the CABG group and in 524 patients (87.0%) in the medical-therapy group (hazard ratio, 0.72; 95% CI, 0.64 to 0.82; P

Original languageEnglish (US)
Pages (from-to)1511-1520
Number of pages10
JournalNew England Journal of Medicine
Volume374
Issue number16
DOIs
StatePublished - Apr 21 2016

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Cardiomyopathies
Coronary Artery Bypass
Group Psychotherapy
Cause of Death
Confidence Intervals
Coronary Artery Disease
Hospitalization
Therapeutics
Left Ventricular Dysfunction
Heart Failure
Guidelines
Survival

ASJC Scopus subject areas

  • Medicine(all)

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Velazquez, E. J., Lee, K. L., Jones, R. H., Al-Khalidi, H. R., Hill, J. A., Panza, J. A., ... Rouleau, J. L. (2016). Coronary-artery bypass surgery in patients with ischemic cardiomyopathy. New England Journal of Medicine, 374(16), 1511-1520. https://doi.org/10.1056/NEJMoa1602001

Coronary-artery bypass surgery in patients with ischemic cardiomyopathy. / Velazquez, Eric J.; Lee, Kerry L.; Jones, Robert H.; Al-Khalidi, Hussein R.; Hill, James A.; Panza, Julio A.; Michler, Robert E.; Bonow, Robert O.; Doenst, Torsten; Petrie, Mark C.; Oh, Jae K.; She, Lilin; Moore, Vanessa L.; Desvigne-Nickens, Patrice; Sopko, George; Rouleau, Jean L.

In: New England Journal of Medicine, Vol. 374, No. 16, 21.04.2016, p. 1511-1520.

Research output: Contribution to journalArticle

Velazquez, EJ, Lee, KL, Jones, RH, Al-Khalidi, HR, Hill, JA, Panza, JA, Michler, RE, Bonow, RO, Doenst, T, Petrie, MC, Oh, JK, She, L, Moore, VL, Desvigne-Nickens, P, Sopko, G & Rouleau, JL 2016, 'Coronary-artery bypass surgery in patients with ischemic cardiomyopathy', New England Journal of Medicine, vol. 374, no. 16, pp. 1511-1520. https://doi.org/10.1056/NEJMoa1602001
Velazquez EJ, Lee KL, Jones RH, Al-Khalidi HR, Hill JA, Panza JA et al. Coronary-artery bypass surgery in patients with ischemic cardiomyopathy. New England Journal of Medicine. 2016 Apr 21;374(16):1511-1520. https://doi.org/10.1056/NEJMoa1602001
Velazquez, Eric J. ; Lee, Kerry L. ; Jones, Robert H. ; Al-Khalidi, Hussein R. ; Hill, James A. ; Panza, Julio A. ; Michler, Robert E. ; Bonow, Robert O. ; Doenst, Torsten ; Petrie, Mark C. ; Oh, Jae K. ; She, Lilin ; Moore, Vanessa L. ; Desvigne-Nickens, Patrice ; Sopko, George ; Rouleau, Jean L. / Coronary-artery bypass surgery in patients with ischemic cardiomyopathy. In: New England Journal of Medicine. 2016 ; Vol. 374, No. 16. pp. 1511-1520.
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abstract = "BACKGROUND The survival benefit of a strategy of coronary-artery bypass grafting (CABG) added to guideline-directed medical therapy, as compared with medical therapy alone, in patients with coronary artery disease, heart failure, and severe left ventricular systolic dysfunction remains unclear. METHODS From July 2002 to 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 undergo CABG plus medical therapy (CABG group, 610 patients) or medical therapy alone (medical-therapy group, 602 patients). The primary outcome was death from any cause. Major secondary outcomes included death from cardiovascular causes and death from any cause or hospitalization for cardiovascular causes. The median duration of follow-up, including the current extended-follow-up study, was 9.8 years. RESULTS A primary outcome event occurred in 359 patients (58.9{\%}) in the CABG group and in 398 patients (66.1{\%}) in the medical-therapy group (hazard ratio with CABG vs. medical therapy, 0.84; 95{\%} confidence interval [CI], 0.73 to 0.97; P = 0.02 by log-rank test). A total of 247 patients (40.5{\%}) in the CABG group and 297 patients (49.3{\%}) in the medical-therapy group died from cardiovascular causes (hazard ratio, 0.79; 95{\%} CI, 0.66 to 0.93; P = 0.006 by log-rank test). Death from any cause or hospitalization for cardiovascular causes occurred in 467 patients (76.6{\%}) in the CABG group and in 524 patients (87.0{\%}) in the medical-therapy group (hazard ratio, 0.72; 95{\%} CI, 0.64 to 0.82; P",
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AU - Velazquez, Eric J.

AU - Lee, Kerry L.

AU - Jones, Robert H.

AU - Al-Khalidi, Hussein R.

AU - Hill, James A.

AU - Panza, Julio A.

AU - Michler, Robert E.

AU - Bonow, Robert O.

AU - Doenst, Torsten

AU - Petrie, Mark C.

AU - Oh, Jae K.

AU - She, Lilin

AU - Moore, Vanessa L.

AU - Desvigne-Nickens, Patrice

AU - Sopko, George

AU - Rouleau, Jean L.

PY - 2016/4/21

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N2 - BACKGROUND The survival benefit of a strategy of coronary-artery bypass grafting (CABG) added to guideline-directed medical therapy, as compared with medical therapy alone, in patients with coronary artery disease, heart failure, and severe left ventricular systolic dysfunction remains unclear. METHODS From July 2002 to 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 undergo CABG plus medical therapy (CABG group, 610 patients) or medical therapy alone (medical-therapy group, 602 patients). The primary outcome was death from any cause. Major secondary outcomes included death from cardiovascular causes and death from any cause or hospitalization for cardiovascular causes. The median duration of follow-up, including the current extended-follow-up study, was 9.8 years. RESULTS A primary outcome event occurred in 359 patients (58.9%) in the CABG group and in 398 patients (66.1%) in the medical-therapy group (hazard ratio with CABG vs. medical therapy, 0.84; 95% confidence interval [CI], 0.73 to 0.97; P = 0.02 by log-rank test). A total of 247 patients (40.5%) in the CABG group and 297 patients (49.3%) in the medical-therapy group died from cardiovascular causes (hazard ratio, 0.79; 95% CI, 0.66 to 0.93; P = 0.006 by log-rank test). Death from any cause or hospitalization for cardiovascular causes occurred in 467 patients (76.6%) in the CABG group and in 524 patients (87.0%) in the medical-therapy group (hazard ratio, 0.72; 95% CI, 0.64 to 0.82; P

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