Open heart surgery improves long-term outcomes for patients with heart disease and heart failure, according to findings presented at the American College of Cardiology’s 65th Annual Scientific Sessions.
Led by researchers at the Duke University Medical Center, this study assessed the safety and efficacy of open heart surgery (known as coronary artery bypass grafting or CABG) in patients with both heart disease and heart failure.
CABG is a common surgical procedure that helps improve blood flow in clogged arteries. While CABG is often used to treat patients with heart disease, patients with heart disease and heart failure have been considered too risky for surgery. Unfortunately, there’s little data on whether surgery is safe and effective in this higher-risk population.
To learn more, researchers conducted the STICH study (Surgical Treatment for Ischemic Heart Failure), which randomized more than 2,000 patients to CABG and standard therapy, or standard therapy alone. Standard therapy typically included a combination of medications, including blood pressure and cholesterol-lowering medication, aspirin and diuretics.
Researchers then followed participants for up to ten years, tracking key outcomes like hospitalizations, heart events, and death.
After analysis, researchers found that CABG increased risk of death in the month after surgery. However, patients undergoing surgery had significantly lower risk of death after ten years than those receiving standard therapy, alone. Patients receiving CABG were also less likely to be hospitalized or need additional heart procedures during the ten years of follow-up.
According to authors, this is the largest study of its kind to confirm that CABG and medical therapy combined improves outcomes in patients with heart disease and heart failure. Conducted at medical centers across 22 countries, the STICH study included a diverse population and had long-term follow-up for nearly all study participants.
Based on findings, it’s possible that more patients with heart disease and heart failure could benefit from surgery than previously imagined. Until now, patients with heart disease and heart failure have had limited treatment options, given their increased risk for surgery. But findings suggest that the benefits of heart surgery likely outweigh the risks for many patients. With future research, experts hope to enhance current guidelines to improve outcomes in patients with heart disease and heart failure.