{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,10]],"date-time":"2026-01-10T01:41:32Z","timestamp":1768009292031,"version":"3.49.0"},"reference-count":21,"publisher":"BMJ","issue":"1","funder":[{"DOI":"10.13039\/100000050","name":"National Heart, Lung, and Blood Institute","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000050","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000098","name":"NIH Clinical Center","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000098","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["Open Heart"],"accepted":{"date-parts":[[2018,1,18]]},"published-print":{"date-parts":[[2018,2]]},"abstract":"<jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>In patients with ischaemic left ventricular dysfunction, coronary artery bypass surgery (CABG) may decrease mortality, but it is not known whether CABG improves functional capacity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Objective<\/jats:title>\n                  <jats:p>To determine whether CABG compared with medical therapy alone (MED) increases 6\u2009min walk distance in patients with ischaemic left ventricular dysfunction and coronary artery disease amenable to revascularisation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>The Surgical Treatment in Ischemic Heart disease trial randomised 1212 patients with ischaemic left ventricular dysfunction to CABG or MED. A 6\u2009min walk distance test was performed both at baseline and at least one follow-up assessment at 4, 12, 24 and\/or 36\u2009months in 409 patients randomised to CABG and 466 to MED. Change in 6\u2009min walk distance between baseline and follow-up were compared by treatment allocation.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>6\u2009min walk distance at baseline for CABG was mean 340\u00b1117\u2009m and for MED 339\u00b1118\u2009m. Change in walk distance from baseline was similar for CABG and MED groups at 4 months (mean +38\u2009vs +28\u2009m), 12 months (+47\u2009vs +36\u2009m), 24 months (+31\u2009vs +34\u2009m) and 36 months (\u22127 vs +7\u2009m), P&gt;0.10 for all. Change in walk distance between CABG and MED groups over all assessments was also similar after adjusting for covariates and imputation for missing values (+8\u2009m, 95% CI \u22127 to 23\u2009m, P=0.29). Results were consistent for subgroups defined by angina, New York Heart Association class \u22653, left ventricular ejection fraction, baseline walk distance and geographic region.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusion<\/jats:title>\n                  <jats:p>In patients with ischaemic left ventricular dysfunction CABG compared with MED alone is known to reduce mortality but is unlikely to result in a clinically significant improvement in functional capacity.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" xlink:href=\"NCT00023595\" specific-use=\"clinicaltrial\">NCT00023595<\/jats:ext-link>.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/openhrt-2017-000752","type":"journal-article","created":{"date-parts":[[2025,9,15]],"date-time":"2025-09-15T16:07:42Z","timestamp":1757952462000},"page":"e000752","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Six-minute walk distance after coronary artery bypass grafting compared with medical therapy in ischaemic cardiomyopathy"],"prefix":"10.1136","volume":"5","author":[{"given":"Ralph A H","family":"Stewart","sequence":"first","affiliation":[{"name":"Green Lane Cardiovascular Service, Auckland City Hospital and University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dominika","family":"Szalewska","sequence":"additional","affiliation":[{"name":"Rehabilitation Medicine, Medical University of Gdansk, Gdansk, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Amanda","family":"Stebbins","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics (HRA), Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA"},{"name":"Division of Cardiology, Departments of Medicine, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hussein R","family":"Al-Khalidi","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics (HRA), Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA"},{"name":"Division of Cardiology, Departments of Medicine, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"John G H","family":"Cleland","sequence":"additional","affiliation":[{"name":"National Heart and Lung Institute, Royal Brompton and Harefield Hospitals, Imperial College, London, UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrzej","family":"Rynkiewicz","sequence":"additional","affiliation":[{"name":"Department of Cardiology and Cardiosurgery, University of Warmia and Mazury, Olsztyn, Poland"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mark H","family":"Drazner","sequence":"additional","affiliation":[{"name":"Department of Cardiology, University of Texas Southwestern Medical Center, Dallas, Texas, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Harvey D","family":"White","sequence":"additional","affiliation":[{"name":"Green Lane Cardiovascular Service, Auckland City Hospital and University of Auckland, Auckland, New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniel B","family":"Mark","sequence":"additional","affiliation":[{"name":"Department of Biostatistics and Bioinformatics (HRA), Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA"},{"name":"Division of Cardiology, Departments of Medicine, Duke Clinical Research Institute, Duke University School of Medicine, Durham, North Carolina, USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ambuj","family":"Roy","sequence":"additional","affiliation":[{"name":"Department of Cardiology, All India Institute of Medical Sciences, New Delhi, India"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Dragana","family":"Kosevic","sequence":"additional","affiliation":[{"name":"Department of Cardiology, Dedinje Cardiovascular Institute, Belgrade, Serbia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Miroslaw","family":"Rajda","sequence":"additional","affiliation":[{"name":"Nova Scotia Health Authority, Queen Elizabeth 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