Mechanisms of Death in the CABG Patch Trial

• DOI: 10.1161/01.cir.99.11.1416
• Publication Date: 2012-06-12T00:42:29Z
• Authors: J. Thomas Bigger; William Whang; Jeffrey N. Rottman; Robert E. Kleiger; Charles D. Gottlieb; Pearila B. Namerow; Richard C. Steinman; N. A. Mark Estes
• Keywords: Heart Failure; Male; Arteriosclerosis; Arrhythmias, Cardiac; Coronary Disease; Defibrillators, Implantable; 3. Good health; Cohort Studies; Hospitalization; Cerebrovascular Disorders; 03 medical and health sciences; Death, Sudden, Cardiac; Dyspnea; Postoperative Complications; 0302 clinical medicine; Cause of Death; Neoplasms; Humans; Female; Life Tables; Coronary Artery Bypass; Anti-Arrhythmia Agents; Proportional Hazards Models

Background —The CABG Patch trial compared prophylactic implantable cardiac-defibrillator (ICD) implantation with no antiarrhythmic therapy in coronary bypass surgery patients who had a left ventricular ejection fraction <0.36 and an abnormal signal-averaged ECG. There were 102 deaths among the 446 ICD group 96 454 control patients, hazard ratio of 1.07 ( P =0.63). The mechanisms death classified, hypotheses tested about effects on arrhythmic nonarrhythmic cardiac Trial Multicenter Automatic Defibrillator Implantation (MADIT). Methods Results 198 reviewed by independent Events Committee classified method Hinkle Thaler. Only 54 (27%) occurred out hospital; 145 (73%) witnessed. Seventy-nine (82%) 76 (75%) due to causes. Cumulative mortality at 42 months was 6.9% 4.0% =0.057). 12.4% 13.0% =0.275). Death pump failure significantly associated >1 hour from onset symptoms, dyspnea within 7 days death, overt heart death. Conclusions —In Trial, reduced 45% without significant effect deaths. Because 71% nonarrhythmic, total not reduced.