Evidence map›Paper›PMID 32386761›Full record

Trial reportThe Journal of thoracic and cardiovascular surgery2022

Renal function and coronary bypass surgery in patients with ischemic heart failure.

Torsten Doenst, Haissam Haddad, Amanda Stebbins, James A Hill, Eric J Velazquez, Kerry L Lee, Jean L Rouleau, George Sopko, Pedro S Farsky, Hussein R Al-Khalidi and 1 more

Abstract readMulticenter StudyRandomized Controlled TrialVideo-Audio Media
In one paragraph

Trial report in The Journal of thoracic and cardiovascular surgery, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors.

Torsten DoenstDepartment of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University of Jena, Jena, Germany. Electronic address: doenst@med.uni-jena.de.
Haissam HaddadDepartment of Medicine, College of Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
Amanda StebbinsDuke Clinical Research Institute, Durham, NC.
James A HillDivision of Cardiovascular Medicine, Department of Medicine, University of Florida, Malcom Randal VAMC, Gainesville, Fla.
Eric J VelazquezSection of Cardiovascular Medicine, Department of Internal Medicine, Yale School of Medicine, New Haven, Conn.
Kerry L LeeDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Duke Clinical Research Institute, Durham, NC.
Jean L RouleauMontreal Heart Institute, University of Montreal, Montreal, Québec, Canada.
George SopkoDivision of Cardiovascular Sciences, National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, Md.
Pedro S FarskyDepartment of Cardiology, Instituto Dante Pazzanese de Cardiologia, Sao Paulo, Brazil; Department of Cardiology, Hospital Israelita Albert Einstein, Sao Paulo, Brazil.
Hussein R Al-KhalidiDepartment of Biostatistics and Bioinformatics, Duke University School of Medicine, Duke Clinical Research Institute, Durham, NC.
Working Group and Surgical Treatment for IsChemic Heart failure Trial Investigators

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
NHLBI NIH HHS R01 HL105853NHLBI NIH HHS U01 HL069013NHLBI NIH HHS U01 HL069015
6 · The paper itself

Abstract

objectiveChronic kidney disease is a known risk factor in cardiovascular disease, but its influence on treatment effect of bypass surgery remains unclear. We assessed the influence of chronic kidney disease on 10-year mortality and cardiovascular outcomes in patients with ischemic heart failure treated with medical therapy (medical treatment) with or without coronary artery bypass grafting.

methodsWe calculated the baseline estimated glomerular filtration rate (Chronic Kidney Disease Epidemiology Collaboration formula, chronic kidney disease stages 1-5) from 1209 patients randomized to medical treatment or coronary artery bypass grafting in the Surgical Treatment for IsChemic Heart failure trial and assessed its effect on outcome.

resultsIn the overall Surgical Treatment for IsChemic Heart failure cohort, patients with chronic kidney disease stages 3 to 5 were older than those with stages 1 and 2 (66-71 years vs 54-59 years) and had more comorbidities. Multivariable modeling revealed an inverse association between estimated glomerular filtration rate and risk of death, cardiovascular death, or cardiovascular rehospitalization (all P < .001, but not for stroke, P = .697). Baseline characteristics of the 2 treatment arms were equal for each chronic kidney disease stage. There were significant improvements in death or cardiovascular rehospitalization with coronary artery bypass grafting (stage 1: hazard ratio, 0.71; confidence interval, 0.53-0.96, P = .02; stage 2: hazard ratio, 0.71; confidence interval, 0.59-0.84, P < .0001; stage 3: hazard ratio, 0.76; confidence interval, 0.53-0.96, P = .03). These data were inconclusive in stages 4 and 5 for insufficient patient numbers (N = 28). There was no significant interaction of estimated glomerular filtration rate with the treatment effect of coronary artery bypass grafting (P = .25 for death and P = .54 for death or cardiovascular rehospitalization).

conclusionsChronic kidney disease is an independent risk factor for mortality in patients with ischemic heart failure with or without coronary artery bypass grafting. However, mild to moderate chronic kidney disease does not appear to influence long-term treatment effects of coronary artery bypass grafting.

Indexed as

Coronary Artery BypassGlomerular Filtration RateAgedCardiovascular AgentsFemaleHeart FailureHumansKidneyMaleMiddle AgedMyocardial IschemiaProspective StudiesRenal Insufficiency, ChronicRisk AssessmentRisk FactorsTime FactorsCardiovascular AgentsCABG treatment effectchronic kidney diseasecoronary artery bypass graftingmedical therapysurvival

Identifiers

PMID32386761
PMCPMC7541611

What OpenQuestion holds

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Registered trials

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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.