{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,1]],"date-time":"2025-12-01T15:07:28Z","timestamp":1764601648794,"version":"3.37.3"},"reference-count":17,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2017,11,2]],"date-time":"2017-11-02T00:00:00Z","timestamp":1509580800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2017,11,2]],"date-time":"2017-11-02T00:00:00Z","timestamp":1509580800000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Sci Rep"],"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The STICH(-ES) trial showed that coronary artery bypass grafting was superior to medical therapy alone in treating ischemic heart failure. However, dosages of disease modifying drugs were not reported. We included 128 (84% male, mean age 66\u2009\u00b1\u200911 years) consecutive patients with ischemic heart failure and an ejection fraction \u226435% undergoing isolated elective coronary artery bypass grafting. We defined optimal medical therapy (OMT) as prescription of \u226550% dosages of guideline recommended medications (i.e. beta-blocker (BB) and renin angiotensin system (RAS) antagonist) plus prescription of a mineralocorticoid receptor antagonist (MRA). The mean logistic EuroSCORE was 12.3\u2009\u00b1\u200913.8%. The five year survival was 74%. At discharge, 111 patients (87%) were on a BB and 106 (83%) were on a RAS antagonist. Forty-nine patients (38%) received an MRA. Only 8 patients (6%) received OMT. A Cox regression analysis revealed EuroSCORE (p\u2009&lt;\u20090.001) and the use of MRA (p\u2009=\u20090.003) and BB (p\u2009=\u20090.037) at discharge as significant predictors of 5 year survival. Prescription rates of heart failure medication are comparable to those reported in the STICH trial, but rates of OMT are very low at admission and discharge. Prescription of BB and MRA was associated with improved survival, highlighting the need for disease management programs and rigorous discharge management.<\/jats:p>","DOI":"10.1038\/s41598-017-15004-5","type":"journal-article","created":{"date-parts":[[2017,10,27]],"date-time":"2017-10-27T09:48:02Z","timestamp":1509097682000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":3,"title":["Quality of medical therapy in heart failure patients undergoing elective revascularisation: A protective effect of disease modifying therapy at discharge"],"prefix":"10.1038","volume":"7","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-3027-7775","authenticated-orcid":false,"given":"Raphael","family":"Wurm","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Huelsmann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marius","family":"Hienert","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veronika","family":"Seidl","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominik","family":"Wiedemann","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guenther","family":"Laufer","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alfred","family":"Kocher","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christopher","family":"Adlbrecht","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Martin","family":"Andreas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2017,11,2]]},"reference":[{"key":"15004_CR1","doi-asserted-by":"publisher","first-page":"1607","DOI":"10.1056\/NEJMoa1100356","volume":"364","author":"EJ Velazquez","year":"2011","unstructured":"Velazquez, E. J. et al. Coronary-artery bypass surgery in patients with left ventricular dysfunction. N Engl J Med. \n                           364, 1607\u20131616 (2011).","journal-title":"N Engl J Med."},{"key":"15004_CR2","doi-asserted-by":"publisher","first-page":"1511","DOI":"10.1056\/NEJMoa1602001","volume":"374","author":"EJ Velazquez","year":"2016","unstructured":"Velazquez, E. J. et al. Coronary-Artery Bypass Surgery in Patients with Ischemic Cardiomyopathy. N Engl J Med. \n                           374, 1511\u20131520 (2016).","journal-title":"N Engl J Med."},{"key":"15004_CR3","doi-asserted-by":"publisher","first-page":"1653","DOI":"10.1093\/eurheartj\/ehi251","volume":"26","author":"M Komajda","year":"2005","unstructured":"Komajda, M. et al. Adherence to guidelines is a predictor of outcome in chronic heart failure: the MAHLER survey. Eur Heart J. \n                           26, 1653\u20131659 (2005).","journal-title":"Eur Heart J."},{"key":"15004_CR4","doi-asserted-by":"publisher","first-page":"891","DOI":"10.1002\/ejhf.592","volume":"18","author":"P Ponikowski","year":"2016","unstructured":"Ponikowski, P. et al. 2016 ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure: The Task Force for the diagnosis and treatment of acute and chronic heart failure of the European Society of Cardiology (ESC). Developed with the special contribution of the Heart Failure Association (HFA) of the ESC. Eur J Heart Fail. \n                           18, 891\u2013975 (2016).","journal-title":"Eur J Heart Fail."},{"key":"15004_CR5","unstructured":"McMurray, J. J. et al. ESC Guidelines for the diagnosis and treatment of acute and chronic heart failure 2012: The Task Force for the Diagnosis and Treatment of Acute and Chronic Heart Failure 2012 of the European Society of Cardiology. Developed in collaboration with the Heart Failure Association (HFA) of the ESC. Eur Heart J. 33, 1787-1847 (2012)."},{"key":"15004_CR6","doi-asserted-by":"publisher","first-page":"1883","DOI":"10.1093\/eurheartj\/ehx026","volume":"38","author":"W Ouwerkerk","year":"2017","unstructured":"Ouwerkerk, W. et al. Determinants and clinical outcome of uptitration of ACE-inhibitors and beta-blockers in patients with heart failure: a prospective European study. Eur Heart J. \n                           38, 1883\u20131890 (2017).","journal-title":"Eur Heart J."},{"key":"15004_CR7","doi-asserted-by":"publisher","first-page":"46","DOI":"10.1093\/eurjhf\/hfs154","volume":"15","author":"AE Moreyra","year":"2013","unstructured":"Moreyra, A. E. et al. Incidence and trends of heart failure admissions after coronary artery bypass grafting surgery. Eur J Heart Fail. \n                           15, 46\u201353 (2013).","journal-title":"Eur J Heart Fail."},{"key":"15004_CR8","doi-asserted-by":"publisher","first-page":"1778","DOI":"10.1016\/j.jacc.2009.07.008","volume":"54","author":"A Miceli","year":"2009","unstructured":"Miceli, A. et al. Effects of angiotensin-converting enzyme inhibitor therapy on clinical outcome in patients undergoing coronary artery bypass grafting. J Am Coll Cardiol. \n                           54, 1778\u20131784 (2009).","journal-title":"J Am Coll Cardiol."},{"key":"15004_CR9","doi-asserted-by":"publisher","first-page":"1781","DOI":"10.1016\/S0735-1097(01)01269-4","volume":"37","author":"AM Richards","year":"2001","unstructured":"Richards, A. M. et al. Plasma N-terminal pro-brain natriuretic peptide and adrenomedullin: prognostic utility and prediction of benefit from carvedilol in chronic ischemic left ventricular dysfunction. Australia-New Zealand Heart Failure Group. J Am Coll Cardiol. \n                           37, 1781\u20131787 (2001).","journal-title":"J Am Coll Cardiol."},{"key":"15004_CR10","doi-asserted-by":"publisher","first-page":"736","DOI":"10.1016\/S0735-1097(03)00789-7","volume":"42","author":"JP Curtis","year":"2003","unstructured":"Curtis, J. P. et al. The association of left ventricular ejection fraction, mortality, and cause of death in stable outpatients with heart failure. J Am Coll Cardiol. \n                           42, 736\u2013742 (2003).","journal-title":"J Am Coll Cardiol."},{"key":"15004_CR11","first-page":"109","volume":"10","author":"O Amir","year":"2008","unstructured":"Amir, O. et al. Usefulness and predictive value of circulating NT-proBNP levels to stratify patients for referral and priority treatment in a specialized outpatient heart failure center. Isr Med Assoc J. \n                           10, 109\u2013112 (2008).","journal-title":"Isr Med Assoc J."},{"key":"15004_CR12","doi-asserted-by":"publisher","first-page":"1439","DOI":"10.1001\/jama.2009.454","volume":"301","author":"CM O\u2019Connor","year":"2009","unstructured":"O\u2019Connor, C. M. et al. Efficacy and safety of exercise training in patients with chronic heart failure: HF-ACTION randomized controlled trial. JAMA. \n                           301, 1439\u20131450 (2009).","journal-title":"JAMA."},{"key":"15004_CR13","doi-asserted-by":"publisher","first-page":"904","DOI":"10.1002\/ejhf.775","volume":"19","author":"S Paolillo","year":"2017","unstructured":"Paolillo, S. et al. Prognostic role of beta-blocker selectivity and dosage regimens in heart failure patients. Insights from the MECKI score database. 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Eur Heart J. \n                           35, 1051\u20131060 (2014).","journal-title":"Eur Heart J."}],"container-title":["Scientific Reports"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-15004-5","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-15004-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-15004-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2022,12,23]],"date-time":"2022-12-23T13:02:20Z","timestamp":1671800540000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.nature.com\/articles\/s41598-017-15004-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,11,2]]},"references-count":17,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2017,12]]}},"alternative-id":["15004"],"URL":"https:\/\/doi.org\/10.1038\/s41598-017-15004-5","relation":{},"ISSN":["2045-2322"],"issn-type":[{"type":"electronic","value":"2045-2322"}],"subject":[],"published":{"date-parts":[[2017,11,2]]},"assertion":[{"value":"26 June 2017","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"20 October 2017","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 November 2017","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"The authors declare that they have no competing interests.","order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}}],"article-number":"14909"}}