Samuel W. Reinhardt, Haocheng Huang, Helen Parise, Tariq Ahmad, Eric J. Velazquez, Kamil F. Faridi
{"title":"Coronary artery bypass surgery improves restricted mean survival time in patients with ischemic cardiomyopathy","authors":"Samuel W. Reinhardt, Haocheng Huang, Helen Parise, Tariq Ahmad, Eric J. Velazquez, Kamil F. Faridi","doi":"10.1016/j.ahjo.2025.100538","DOIUrl":null,"url":null,"abstract":"<div><h3>Introduction</h3><div>Clinical trials commonly use Cox proportional hazards models, which may be inaccurate when evaluating procedural interventions. Restricted mean survival time (RMST) is an alternative outcome measure that quantifies treatment effects without assuming proportional hazards.</div></div><div><h3>Methods</h3><div>We determined outcomes based on RMST in the Surgical Treatment for Ischemic Heart Failure (STICH) trial, an international multicenter randomized clinical trial comparing coronary artery bypass grafting (CABG) plus optimal medical therapy to optimal medical therapy alone in patients with ischemic cardiomyopathy.</div></div><div><h3>Results</h3><div>For the primary endpoint of all-cause mortality, CABG plus medical therapy was superior to medical therapy alone at 10 years of follow up when using measures of RMST. In subgroup analyses evaluating all-cause mortality, there was a greater beneficial effect of CABG for racial/ethnic minorities vs. white patients.</div></div><div><h3>Conclusions</h3><div>These findings reinforce the benefit of CABG and can be used to help quantify anticipated outcomes for patients with ischemic cardiomyopathy.</div></div>","PeriodicalId":72158,"journal":{"name":"American heart journal plus : cardiology research and practice","volume":"54 ","pages":"Article 100538"},"PeriodicalIF":1.3000,"publicationDate":"2025-04-04","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"American heart journal plus : cardiology research and practice","FirstCategoryId":"1085","ListUrlMain":"https://www.sciencedirect.com/science/article/pii/S2666602225000412","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q3","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
引用次数: 0
Abstract
Introduction
Clinical trials commonly use Cox proportional hazards models, which may be inaccurate when evaluating procedural interventions. Restricted mean survival time (RMST) is an alternative outcome measure that quantifies treatment effects without assuming proportional hazards.
Methods
We determined outcomes based on RMST in the Surgical Treatment for Ischemic Heart Failure (STICH) trial, an international multicenter randomized clinical trial comparing coronary artery bypass grafting (CABG) plus optimal medical therapy to optimal medical therapy alone in patients with ischemic cardiomyopathy.
Results
For the primary endpoint of all-cause mortality, CABG plus medical therapy was superior to medical therapy alone at 10 years of follow up when using measures of RMST. In subgroup analyses evaluating all-cause mortality, there was a greater beneficial effect of CABG for racial/ethnic minorities vs. white patients.
Conclusions
These findings reinforce the benefit of CABG and can be used to help quantify anticipated outcomes for patients with ischemic cardiomyopathy.