Evidence map›Paper›PMID 25023813›Full record

Trial reportJACC. Heart failure2014

Exercise capacity and mortality in patients with ischemic left ventricular dysfunction randomized to coronary artery bypass graft surgery or medical therapy: an analysis from the STICH trial (Surgical Treatment for Ischemic Heart Failure).

Ralph A H Stewart, Dominika Szalewska, Lilin She, Kerry L Lee, Mark H Drazner, Barbara Lubiszewska, Dragana Kosevic, Permyos Ruengsakulrach, José C Nicolau, Benoit Coutu and 7 more

Registry-linked trialOpen access · greenAbstract readComparative StudyMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in JACC. Heart failure, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00023595 (Surgical Treatment for Ischemic Heart Failure), which is not on this map. Cited by 18 papers.

0numbers the graph read from it
0cells of the map it votes in
18citing papers in PubMed
2.6field-weighted citation impact, top 10% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT00023595 phase3completednot on this map

Surgical Treatment for Ischemic Heart Failure (STICH)

TypeinterventionalSponsorDuke UniversityRan2002 to 2015Enrolled2,136ConditionsCardiovascular Diseases, Coronary Disease, Heart Failure, Congestive, Heart DiseasesArmsCABG surgery plus MED, Active Medication Alone, CABG plus MED and SVR
3 · Its place in the literature

Who cites it

18 citing papers in PubMed, 54 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 13 institutions in 9 countries.

Ralph A H StewartGreen Lane Cardiovascular Service, Auckland City Hospital, and University of Auckland, Auckland, New Zealand. Electronic address: rstewart@adhb.govt.nz.
Dominika SzalewskaMedical University of Gdansk, Department of Rehabilitation, Gdansk, Poland.
Lilin SheDuke Clinical Research Institute, Clinical Trial Biostatistics, Durham, North Carolina.
Kerry L LeeDuke Clinical Research Institute, Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, North Carolina.
Mark H DraznerUniversity of Texas Southwestern Medical Center, Dallas, Texas.
Barbara LubiszewskaNational Institute of Cardiology, Warsaw, Poland.
Dragana KosevicDedinje Cardiovascular Institute, Belgrade, Serbia.
Permyos RuengsakulrachBangkok Heart Hospital, Bangkok Hospital Group, Bangkok, Thailand.
José C NicolauHeart Institute (InCor), University of São Paulo Medical School, São Paulo, Brazil.
Benoit CoutuHotel-Dieu du CHUM, Montreal, Canada.
Shiv K ChoudharyAll India Institute of Medical Sciences, New Delhi, India.
Daniel B MarkDuke Clinical Research Institute, Department of Medicine-Cardiology, Duke University School of Medicine, Durham, North Carolina.
John G F ClelandCastle Hill Hospital/Hull Royal Infirmary, Kingston-upon-Hull, United Kingdom.
Ileana L PiñaAlbert Einstein College of Medicine, Montefiore Medical Center, New York, New York.
Eric J VelazquezDuke Clinical Research Institute, Department of Medicine-Cardiology, Duke University School of Medicine, Durham, North Carolina.
Andrzej RynkiewiczUniversity of Waria and Mazury, Department of Cardiology and Cardiosurgery, Olsztyn, Poland.
Harvey WhiteGreen Lane Cardiovascular Service, Auckland City Hospital, and University of Auckland, Auckland, New Zealand.
Duke University · USUniversity of Auckland · NZAlbert Einstein College of Medicine · USAll India Institute of Medical Sciences · INBangkok Hospital · THCardiovascular Institute of the South · USGdańsk Medical University · PLHôtel-Dieu de Montréal · CAHull Royal Infirmary · GBInstitute of Cardiology · PLThe University of Texas Southwestern Medical Center · USUniversidade de São Paulo · BRUniversity of Warmia and Mazury in Olsztyn · PL

Funding

STICH Trial-Coordinating CenterU01HL069015 · NHLBI · DUKE UNIVERSITY · PI JONES, ROBERT H · 2002 to 2011
$27.3M
STICHESR01HL105853 · NHLBI · DUKE UNIVERSITY · PI AL-KHALIDI, HUSSEIN · 2011 to 2015
$10.2M
STICH Trial-Statistical and Data Coordinatiing CenterU01HL069013 · NHLBI · DUKE UNIVERSITY · PI LEE, KERRY L · 2002 to 2010
$5.0M
Medical Research Council MC_UU_12015/5NHLBI NIH HHS R01 HL105853NHLBI NIH HHS U01 HL069013NHLBI NIH HHS U01 HL069015NHLBI NIH HHS U01HL69013NHLBI NIH HHS U01HL69015
6 · The paper itself

Abstract

objectivesThe objective of this study was to assess the prognostic significance of exercise capacity in patients with ischemic left ventricular (LV) dysfunction eligible for coronary artery bypass graft surgery (CABG).

backgroundPoor exercise capacity is associated with mortality, but it is not known how this influences the benefits and risks of CABG compared with medical therapy.

methodsIn an exploratory analysis, physical activity was assessed by questionnaire and 6-min walk test in 1,212 patients before randomization to CABG (n = 610) or medical management (n = 602) in the STICH (Surgical Treatment for Ischemic Heart Failure) trial. Mortality (n = 462) was compared by treatment allocation during 56 months (interquartile range: 48 to 68 months) of follow-up for subjects able (n = 682) and unable (n = 530) to walk 300 m in 6 min and with less (Physical Ability Score [PAS] >55, n = 749) and more (PAS ≤55, n = 433) limitation by dyspnea or fatigue.

resultsCompared with medical therapy, mortality was lower for patients randomized to CABG who walked ≥300 m (hazard ratio [HR]: 0.77; 95% confidence interval [CI]: 0.59 to 0.99; p = 0.038) and those with a PAS >55 (HR: 0.79; 95% CI: 0.62 to 1.01; p = 0.061). Patients unable to walk 300 m or with a PAS ≤55 had higher mortality during the first 60 days with CABG (HR: 3.24; 95% CI: 1.64 to 6.83; p = 0.002) and no significant benefit from CABG during total follow-up (HR: 0.95; 95% CI: 0.75 to 1.19; p = 0.626; interaction p = 0.167).

conclusionsThese observations suggest that patients with ischemic left ventricular dysfunction and poor exercise capacity have increased early risk and similar 5-year mortality with CABG compared with medical therapy, whereas those with better exercise capacity have improved survival with CABG. (Comparison of Surgical and Medical Treatment for Congestive Heart Failure and Coronary Artery Disease [STICH]; NCT00023595).

Indexed as

Coronary Artery BypassExerciseExercise TestExercise ToleranceFemaleHeart FailureHumansKaplan-Meier EstimateMaleMiddle AgedMyocardial IschemiaRisk FactorsTreatment OutcomeVentricular Dysfunction, Leftcoronary diseaseheart failuresurgerytrials

Identifiers

PMID25023813
PMCPMC4127151
OpenAlexW123462012

What OpenQuestion holds

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Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.