title: Clinical characteristics and outcomes of patients with and without diabetes in the Surgical Treatment for Ischemic Heart Failure (STICH) trial.
abstract: OBJECTIVE
  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.
  
  
  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.
authors.affiliation: Department of Cardiology, Changi General Hospital, Singapore.
authors.forename: Michael R
authors.initials: MR
authors.lastname: MacDonald
authors.affiliation: Duke Clinical Research Institute, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Lilin
authors.initials: L
authors.lastname: She
authors.affiliation: Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich Schiller University, Jena, Germany.
authors.forename: Torsten
authors.initials: T
authors.lastname: Doenst
authors.affiliation: The Ohio State University Wexner Medical Center, Columbus, OH, USA.
authors.forename: Philip F
authors.initials: PF
authors.lastname: Binkley
authors.affiliation: Montréal Heart Institute, Université de Montréal, Canada.
authors.forename: Jean L
authors.initials: JL
authors.lastname: Rouleau
authors.affiliation: National Heart Centre, Singapore.
authors.forename: Ru-San
authors.initials: RS
authors.lastname: Tan
authors.affiliation: Department of Biostatistics and Bioinformatics, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Kerry L
authors.initials: KL
authors.lastname: Lee
authors.affiliation: Department of Cardiology, University of Florida, Jacksonville, FL, USA.
authors.forename: Alan B
authors.initials: AB
authors.lastname: Miller
authors.affiliation: National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: George
authors.initials: G
authors.lastname: Sopko
authors.affiliation: Department of Rehabilitation, Medical University of Gdansk, Gdansk, Poland.
authors.forename: Dominika
authors.initials: D
authors.lastname: Szalewska
authors.affiliation: National Heart, Lung, and Blood Institute, National Institutes of Health, Bethesda, MD, USA.
authors.forename: Myron A
authors.initials: MA
authors.lastname: Waclawiw
authors.affiliation: Institute of Cardiology, Warsaw, Poland.
authors.forename: Rafal
authors.initials: R
authors.lastname: Dabrowski
authors.affiliation: IRCCS Policlinico San Donato, Milan, Italy.
authors.forename: Serenella
authors.initials: S
authors.lastname: Castelvecchio
authors.affiliation: Department of Medicine II, Division of Cardiology, Medical University of Vienna, Austria.
authors.forename: Christopher
authors.initials: C
authors.lastname: Adlbrecht
authors.affiliation: Department of Surgery, Montefiore Medical Center/Albert Einstein College of Medicine, New York City, NY, USA.
authors.forename: Robert E
authors.initials: RE
authors.lastname: Michler
authors.affiliation: Department of Medicine, Mayo Clinic, Rochester, MN, USA.
authors.forename: Jae K
authors.initials: JK
authors.lastname: Oh
authors.affiliation: Department of Medicine-Cardiology, Duke University School of Medicine, Durham, NC, USA.
authors.forename: Eric J
authors.initials: EJ
authors.lastname: Velazquez
authors.affiliation: Scottish National Advanced Heart Failure Service, Golden Jubilee National Hospital, and University of Glasgow, Glasgow, UK.
authors.forename: Mark C
authors.initials: MC
authors.lastname: Petrie
mesh_terms: D000368:Aged; D001026:Coronary Artery Bypass; D048909:Diabetes Complications; D005260:Female; D006333:Heart Failure / Q000503:physiopathology / Q000601:surgery*; D006801:Humans; D008297:Male; D008875:Middle Aged; D017202:Myocardial Ischemia / Q000503:physiopathology / Q000601:surgery*; D011446:Prospective Studies; D013318:Stroke Volume / Q000502:physiology; D016277:Ventricular Function, Left / Q000502:physiology
keywords: Coronary artery bypass graft; Diabetes; Heart failure; Ischaemic heart disease