Severity of remodeling, myocardial viability, and survival in ischemic LV dysfunction after surgical revascularization

STICH Trial Investigators

Research output: Contribution to journalArticle

28 Citations (Scopus)

Abstract

Objectives This study sought to test the hypothesis that end-systolic volume (ESV), as a marker of severity of left ventricular (LV) remodeling, influences the relationship between myocardial viability and survival in patients with coronary artery disease and LV systolic dysfunction. Background Retrospective studies of ischemic LV dysfunction suggest that the severity of LV remodeling determines whether myocardial viability predicts improved survival with surgical compared with medical therapy, with coronary artery bypass grafting (CABG) only benefitting patients with viable myocardium who have smaller ESV. However, this has not been tested prospectively. Methods Interactions of end-systolic volume index (ESVI), myocardial viability, and treatment with respect to survival were assessed in patients in the prospective randomized STICH (Comparison of Surgical and Medical Treatment for Congestive Heart Failure and Coronary Artery Disease) trial of CABG versus medical therapy who underwent viability assessment (n = 601; age 61 ± 9 years; ejection fraction 2 (hazard ratio [HR]: 0.85; 95% confidence interval [CI]: 0.56 to 1.29) was no different than in patients with viability and ESVI >84 ml/m2 (HR: 0.87; 95% CI: 0.57 to 1.31). Other ESVI thresholds yielded similar results, including ESVI

Original languageEnglish (US)
Pages (from-to)1121-1129
Number of pages9
JournalJACC: Cardiovascular Imaging
Volume8
Issue number10
DOIs
StatePublished - Oct 1 2015

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Left Ventricular Dysfunction
Ventricular Remodeling
Survival
Coronary Artery Bypass
Coronary Artery Disease
Confidence Intervals
Therapeutics
Myocardium
Heart Failure
Retrospective Studies

Keywords

  • coronary artery bypass surgery
  • coronary artery disease
  • heart failure
  • myocardial viability

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine
  • Radiology Nuclear Medicine and imaging

Cite this

Severity of remodeling, myocardial viability, and survival in ischemic LV dysfunction after surgical revascularization. / STICH Trial Investigators.

In: JACC: Cardiovascular Imaging, Vol. 8, No. 10, 01.10.2015, p. 1121-1129.

Research output: Contribution to journalArticle

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abstract = "Objectives This study sought to test the hypothesis that end-systolic volume (ESV), as a marker of severity of left ventricular (LV) remodeling, influences the relationship between myocardial viability and survival in patients with coronary artery disease and LV systolic dysfunction. Background Retrospective studies of ischemic LV dysfunction suggest that the severity of LV remodeling determines whether myocardial viability predicts improved survival with surgical compared with medical therapy, with coronary artery bypass grafting (CABG) only benefitting patients with viable myocardium who have smaller ESV. However, this has not been tested prospectively. Methods Interactions of end-systolic volume index (ESVI), myocardial viability, and treatment with respect to survival were assessed in patients in the prospective randomized STICH (Comparison of Surgical and Medical Treatment for Congestive Heart Failure and Coronary Artery Disease) trial of CABG versus medical therapy who underwent viability assessment (n = 601; age 61 ± 9 years; ejection fraction 2 (hazard ratio [HR]: 0.85; 95{\%} confidence interval [CI]: 0.56 to 1.29) was no different than in patients with viability and ESVI >84 ml/m2 (HR: 0.87; 95{\%} CI: 0.57 to 1.31). Other ESVI thresholds yielded similar results, including ESVI",
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AU - STICH Trial Investigators

AU - Bonow, Robert O.

AU - Castelvecchio, Serenella

AU - Panza, Julio A.

AU - Berman, Daniel S.

AU - Velazquez, Eric J.

AU - Michler, Robert E.

AU - She, Lilin

AU - Holly, Thomas A.

AU - Desvigne-Nickens, Patrice

AU - Kosevic, Dragana

AU - Rajda, Miroslaw

AU - Chrzanowski, Lukasz

AU - Deja, Marek

AU - Lee, Kerry L.

AU - White, Harvey

AU - Oh, Jae K.

AU - Doenst, Torsten

AU - Hill, James A.

AU - Rouleau, Jean L.

AU - Menicanti, Lorenzo

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AB - Objectives This study sought to test the hypothesis that end-systolic volume (ESV), as a marker of severity of left ventricular (LV) remodeling, influences the relationship between myocardial viability and survival in patients with coronary artery disease and LV systolic dysfunction. Background Retrospective studies of ischemic LV dysfunction suggest that the severity of LV remodeling determines whether myocardial viability predicts improved survival with surgical compared with medical therapy, with coronary artery bypass grafting (CABG) only benefitting patients with viable myocardium who have smaller ESV. However, this has not been tested prospectively. Methods Interactions of end-systolic volume index (ESVI), myocardial viability, and treatment with respect to survival were assessed in patients in the prospective randomized STICH (Comparison of Surgical and Medical Treatment for Congestive Heart Failure and Coronary Artery Disease) trial of CABG versus medical therapy who underwent viability assessment (n = 601; age 61 ± 9 years; ejection fraction 2 (hazard ratio [HR]: 0.85; 95% confidence interval [CI]: 0.56 to 1.29) was no different than in patients with viability and ESVI >84 ml/m2 (HR: 0.87; 95% CI: 0.57 to 1.31). Other ESVI thresholds yielded similar results, including ESVI

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