Insights from the STICH trial: Change in left ventricular size after coronary artery bypass grafting with and without surgical ventricular reconstruction

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Presentation transcript:

Insights from the STICH trial: Change in left ventricular size after coronary artery bypass grafting with and without surgical ventricular reconstruction Robert E. Michler, MD, Jean L. Rouleau, MD, Hussein R. Al-Khalidi, PhD, Robert O. Bonow, MD, Patricia A. Pellikka, MD, Gerald M. Pohost, MD, Thomas A. Holly, MD, Jae K. Oh, MD, Francois Dagenais, MD, Carmelo Milano, MD, Krzysztof Wrobel, MD, Jan Pirk, MD, DSc, Imtiaz S. Ali, MD, Robert H. Jones, MD, Eric J. Velazquez, MD, Kerry L. Lee, PhD, Marisa Di Donato, MD The Journal of Thoracic and Cardiovascular Surgery Volume 146, Issue 5, Pages 1139-1145.e6 (November 2013) DOI: 10.1016/j.jtcvs.2012.09.007 Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 1 Rolling 4-year Kaplan-Meier (KM) estimates by operation received and postoperative (post-op) left ventricular end-systolic volume index (LVESVI) for 555 patients with paired LVESVI data. Total group size, 150; increment, 1. CABG, Coronary artery bypass grafting; SVR, surgical ventricular reconstruction. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 1139-1145.e6DOI: (10.1016/j.jtcvs.2012.09.007) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 2 Cumulative risk of death: coronary artery bypass grafting plus surgical ventricular reconstruction patients (n = 259) and postoperative left ventricular end-systolic volume index (LVESVI) less than or ≥60 mL/m2. HR, Hazard ratio; CI, confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 1139-1145.e6DOI: (10.1016/j.jtcvs.2012.09.007) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure 3 Cumulative risk of death: coronary artery bypass grafting (CABG) plus surgical ventricular reconstruction (SVR) and reduction in postoperative left ventricular end-systolic volume index (LVESVI) less than or ≥30% of baseline LVESVI. HR, Hazard ratio; CI, confidence interval. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 1139-1145.e6DOI: (10.1016/j.jtcvs.2012.09.007) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure E1 Paired left ventricular studies before and after operation in 979 surgical ventricular reconstruction hypothesis patients. CMR, Cardiac magnetic resonance; core lab, Core Laboratories; ECHO, echocardiography; ESVI, end-systolic volume index; post-op, postoperative; RN, radionuclide; SPECT, single photon emission computed tomography. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 1139-1145.e6DOI: (10.1016/j.jtcvs.2012.09.007) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure E2 All-cause mortality by treatment received in Surgical Treatment for Ischemic Heart Failure. CABG, Coronary artery bypass grafting; SVR, surgical ventricular reconstruction. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 1139-1145.e6DOI: (10.1016/j.jtcvs.2012.09.007) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure E3 Cumulative risk of death: 555 as-treated patients with same (paired) baseline and 4-month imaging modality. CABG, Coronary artery bypass grafting; CI, confidence interval; HR, hazard ratio; SVR, surgical vascular reconstruction. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 1139-1145.e6DOI: (10.1016/j.jtcvs.2012.09.007) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure E4 Preoperative to postoperative change in left ventricular end-systolic volume index (LVESVI) by operation received for (A) patients with baseline LVESVI less than 60 mL/m2, (B) patients with baseline LVESVI 60–90 mL/m2, and (C) patients with baseline LVESVI greater than 90 mL/m2. CABG, Coronary artery bypass grafting; SVR, surgical vascular reconstruction; SD, standard deviation. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 1139-1145.e6DOI: (10.1016/j.jtcvs.2012.09.007) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure E4 Preoperative to postoperative change in left ventricular end-systolic volume index (LVESVI) by operation received for (A) patients with baseline LVESVI less than 60 mL/m2, (B) patients with baseline LVESVI 60–90 mL/m2, and (C) patients with baseline LVESVI greater than 90 mL/m2. CABG, Coronary artery bypass grafting; SVR, surgical vascular reconstruction; SD, standard deviation. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 1139-1145.e6DOI: (10.1016/j.jtcvs.2012.09.007) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure E5 All-cause mortality by left ventricular end-systolic volume index (LVESVI) group and change from preoperative (Pre-Op) LVESVI. CABG, Coronary artery bypass grafting; SVR, surgical vascular reconstruction. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 1139-1145.e6DOI: (10.1016/j.jtcvs.2012.09.007) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure E6 Cumulative risk of death for coronary artery bypass grafting (CABG) alone patients and postoperative (Post) left ventricular end-systolic volume index (LVESVI) less than or 60 mL/m2 or more. CI, Confidence interval; HR, hazard ratio. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 1139-1145.e6DOI: (10.1016/j.jtcvs.2012.09.007) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions

Figure E7 Cumulative risk of death for coronary artery bypass grafting (CABG) alone patients and reduction in postoperative (Post) left ventricular end-systolic volume index (LVESVI) less than or 30% or more of baseline LVESVI. CI, Confidence interval; HR, hazard ratio. The Journal of Thoracic and Cardiovascular Surgery 2013 146, 1139-1145.e6DOI: (10.1016/j.jtcvs.2012.09.007) Copyright © 2013 The American Association for Thoracic Surgery Terms and Conditions