Clinical characteristics and outcomes of patients with and without diabetes in the Surgical Treatment for Ischemic Heart Failure (STICH) trial
Open accessAbstract
AIMS: Hypothesis 1 of the Surgical Treatment for Ischemic Heart Failure (STICH) trial enrolled 1212 patients with an LVEF of ≤35% and CAD amenable to coronary artery bypass grafting (CABG). Patients were randomized to CABG and optimal medical therapy (MED) or MED alone. The objective was to assess whether or not patients with diabetes mellitus (DM) enrolled in the STICH trial would have greater benefit from CABG than patients without DM. METHODS AND RESULTS: The characteristics and clinical outcomes of patients with and without DM randomized to CABG and MED or MED alone were compared. DM was present in 40%. At baseline, patients with DM had more triple vessel CAD, higher LVEF, and smaller left ventricular volumes. In patients with DM, the primary outcome of all-cause mortality occurred in 39% of patients in the MED group and 39% in the CABG group [hazard ratio (HR) with CABG 0.96, 95% confidence interval (CI) 0.73-1.26]. In patients without DM, the primary outcome occurred in 41% of patients in the MED group and 32% in the CABG group (HR with CABG 0.80, 95% CI 0.63-1.02). While numerically it would appear that the treatment effect of CABG is blunted in patients with DM, there was no significant interaction between DM and treatment group on formal statistical testing. CONCLUSIONS: Patients with DM enrolled in the STICH trial had more triple vessel disease, smaller hearts, and higher LVEF than those without DM. CABG did not exert greater benefit in patients with DM.
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In the subanalysis of the STICH trial, there was no significant difference between patients with (40%) and without T2DM with respect to the primary outcome of all-cause mortality.
“In the subanalysis of the STICH trial, there was no significant difference between patients with (40%) and without T2DM with respect to the primary outcome of all-cause mortality.177”
From Type 2 diabetes mellitus and heart failure: A position statement from the Heart Failure Association of the European Society of Cardiology (2018) · cites this paper as [177]
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ResultInfluential
- Authors
- MacDonald, M. R., She, L., Doenst, T., Binkley, P. F., Rouleau, J. L., Tan, R.-S., Lee, K. L., Miller, A. B., Sopko, G., Szalewska, D., Waclawiw, M. A., Dabrowski, R., Castelvecchio, S., Adlbrecht, C., Michler, R. E., Oh, J. K., Velazquez, E. J., & Petrie, M. C.
- Affiliations
- Changi General Hospital (SG)
- Duke University (US)
- Jena University Hospital (DE)
- The Ohio State University Wexner Medical Center (US)
- Montreal Heart Institute (CA)
- National Heart Centre Singapore (SG)
- University of Florida (US)
- National Institutes of Health (US)
- Gdańsk Medical University (PL)
- Institute of Cardiology , Warsaw ,
- IRCCS Policlinico San Donato (IT)
- Medical University of Vienna (AT)
- Albert Einstein College of Medicine (US)
- Mayo Clinic (US)
- Golden Jubilee National Hospital (GB)
- Corresponding author
- MacDonald, Michael R.
- ORCID
- Venue
- European Journal of Heart Failure
- Publisher
- Oxford University Press (OUP)
- Published
- 2015-05-26
- Volume
- 17
- Issue
- 7
- Pages
- 725-734
- ISSN
- 1388-9842 (ISSN-L)
- 1879-0844
- PMC
- PMC4668269
- OpenAlex
- W2098199229
- Cited by
- 24
- References
- 22
- Citations by year
- 2025: 5 · 2023: 1 · 2021: 4 · 2020: 2 · 2019: 2 · 2018: 3 · 2017: 4 · 2016: 3
- FWCI
- 3.36
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- European Journal of Heart Failure (publishedVersion)
- PubMed (publishedVersion)
- PubMed Central (acceptedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (submittedVersion)
- Funders
- National Heart, Lung, and Blood Institute (U01HL69015, U01HL69013)
- National Institutes of Health (NCT00023595)
- Topics
- Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Cardiovascular Function and Risk Factors
- Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
- Keywords
- diabetes mellitus, ischemic heart failure, coronary artery bypass grafting, optimal medical therapy, STICH trial, all-cause mortality, left ventricular ejection fraction, three-vessel coronary artery disease, treatment effect heterogeneity
- MeSH terms
- Aged, Coronary Artery Bypass, Female, Heart Failure, Humans, Male, Middle Aged, Prospective Studies, Stroke Volume, Ventricular Function, Left, Myocardial Ischemia, Diabetes Complications
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