Monday, March 30, 2009

Late-breaking clinical trial: Results of surgical treatment for heart failure
By Kelly Winget, DCRI Communications

A new study that looked at whether it is better for patients with heart failure to have a coronary artery bypass graft (CABG) surgery to restore blood flow, or CABG in addition to left ventricular reconstruction found that the additional procedure did not provide a measurable benefit for patients.

The trial, STICH (Surgical Treatment for Ischemic Heart Failure), included a clinical study as well as an Economics and Quality of Life study. The DCRI's Robert Jones, MD, lead author of the study, presented the clinical findings Sunday, March 29 at a late-breaking clinical trial session at the American College of Cardiology Annual Scientific Session. The DCRI's Daniel Mark, MD, MPH, presented findings on the economic and quality of life impact on Tuesday, March 31.

CABG is a procedure where surgeons graft a new artery or vein around diseased coronary arteries and then reroute the heart's blood flow through the new artery or vein. Left ventricular reconstruction removes damaged sections and reshapes the left ventricle of the heart to be a more normal size. For patients who have heart failure, their hearts can become enlarged as the heart tries to pump more blood, but the stretching weakens the heart.

The study enrolled 1,000 patients between 2002 and 2006. All patients who were physically able to participate in a six-minute walk test did so when they were enrolled in the study, four months after the surgery, and then annually after that.

The patients who had CABG and the ventricular reconstruction were able to walk slightly further at four months after the surgery than those patients who only had the CABG procedure, but the overall improvements after surgery were similar in both groups. There was virtually no difference in the risks for dying or being readmitted to the hospital among the patients who had CABG and those who both procedures.

Other DCRI researchers involved with the study include Eric Velazquez, MD, Christopher O'Connor, MD, Gena Renkin, MPH, RD, and senior author Kerry Lee, PhD.

Click here to read the full article in the New England Journal of Medicine.