Surgical Treatment of Ischemic Heart Failure Trial
Introduction
The Surgical Treatment for Ischemic Heart Failure (STICH) randomized trial compared coronary artery bypass surgery plus medical therapy (CABG) with medical therapy alone (MED) in 1,212 patients with left ventricular ejection fraction ≤ 0.35 and coronary artery disease. Primary clinical results were published in April 2011, and showed that CABG resulted in no statistically significant difference in all-cause mortality after a median follow-up of 56 months (P=0.12). Quality of life outcomes are a major secondary endpoint of STICH.
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Hypothesis
The addition of CABG to medical therapy in patients with ischemic heart failure will improve heart failure symptoms and health-related quality of life.
Methods
The STICH quality of life (QOL) battery included the Kansas City Cardiomyopathy Questionnaire (KCCQ), the Seattle Angina Questionnaire (SAQ), the SF-12 plus 5 subscales from the Medical Outcome Study Short Form-36 (SF-36), the Center for Epidemiologic Studies-Depression (CES-D) scale, and the EQ-5D. QOL data were collected at baseline, 4, 12, 24, and 36 months post randomization.
Results
We collected baseline data on 99% of patients, with 88% of eligible QOL data collected during follow-up. Treatment groups were well balanced at baseline.Empty Cell Baseline QOL Data Empty Cell CABG (N=610) MED (N=602) KCCQ Overall Summary Score 62 (44,77) 62 (45,80) Quality of Life 50 (33,67) 50 (33,67) SAQ Angina Frequency 80 (60,100) 80 (60,100) Angina Stability 50 (50,75) 50 (50,75) Quality of Life 50 (33,75) 58 (33,83) SF-12 Physical Component 38 (34,42) 38 (34,42) Mental Component 44 (35,56) 46 (35,56) CES-D Depression, % Depressed (≥16)
Conclusions
Comparison by ITT of the primary QOL endpoint, heart failure-related QOL assessed with the KCCQ, along with the secondary QOL measures will be presented.