2011
DOI: 10.1056/nejmoa1100356
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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… Show more

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Cited by 1,010 publications
(590 citation statements)
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References 28 publications
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“…In these two cases, this improvement in longitudinal shortening helped improve overall systolic function as also reflected in ejection fractions. If findings from the STICH trial4 (median LVEF 28% and 27% in the medically treated group and CABG group, respectively) had been extrapolated to our patients, they may not have been revascularized. Although we cannot tell what would have happened to our patients if not revascularized but conservatively treated with heart failure medication, we believe that the impressive increases in LVEF with concomitant improvements in NYHA class from IV to I were probably largely due to the revascularization in itself.…”
Section: Discussionmentioning
confidence: 98%
“…In these two cases, this improvement in longitudinal shortening helped improve overall systolic function as also reflected in ejection fractions. If findings from the STICH trial4 (median LVEF 28% and 27% in the medically treated group and CABG group, respectively) had been extrapolated to our patients, they may not have been revascularized. Although we cannot tell what would have happened to our patients if not revascularized but conservatively treated with heart failure medication, we believe that the impressive increases in LVEF with concomitant improvements in NYHA class from IV to I were probably largely due to the revascularization in itself.…”
Section: Discussionmentioning
confidence: 98%
“…Subsequent nonrandomized studies have suggested favorable outcomes with CABG in patients with adverse prognostic indicators [5][6][7] . The STICH trial was the first to compare modern and optimum medical management alone or in combination with CABG in patients with ischemic cardiomyopathy and an LVEF of ≤35% [8] .…”
Section: Discussionmentioning
confidence: 99%
“…Most patients in the STICH trial, however, did not have severe clinical HF, and results of follow-up echocardiograms were not reported [8] . The 2013 American College of Cardiology Foundation and American Heart Association guidelines gave class IIa indication both for medical management and for CABG in patients with severe left ventricular dysfunction, HF, and significant CAD [9] .…”
Section: Discussionmentioning
confidence: 99%
“…The HEART (Heart Failure Revascularization Trial) was an unblinded clinical study that aimed to randomize 800 patients with symptomatic HF, LV ejection fraction < 35%, and evidence of substantial myocardial viability to either conservative management or coronary angiography with the intention of revascularization [23]. Unfortunately, the study was stopped early due to problems with recruiting and funding.…”
Section: Is Viability Imaging Still Relevant?mentioning
confidence: 99%