Key result
Surgical therapy linked to ~67% lower sudden cardiac death rate vs medical therapy.
Why the study?
The effect of medical versus surgical treatment on subsequent sudden cardiac death in patients with significant coronary artery disease was unclear.
Does surgical therapy reduce sudden cardiac death compared to medical therapy in patients with significant coronary artery disease?
Cohort (n=13,476)
Does surgical therapy reduce sudden cardiac death compared to medical therapy in patients with significant coronary artery disease?
Absolute Event Rate: 1.6% vs 4.9%
p-value: p=<0.0001
Surgical revascularization is associated with a significant reduction in sudden cardiac death compared to medical therapy in patients with coronary artery disease, particularly in high-risk patients with three-vessel disease and a history of congestive heart failure.
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May support surgical evaluation in high-risk CAD; leaves open causality and needs RCTs before practice change.
Holmes et al. (1986) conducted a cohort in Coronary artery disease (n=13,476). Surgical treatment vs. Medical treatment was evaluated on Sudden cardiac death (p=<0.0001). Surgical treatment was associated with a lower rate of sudden cardiac death compared to medical treatment (1.6% vs 4.9%, p<0.0001), with the reduction most pronounced in high-risk patients.
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