%0 Journal Article %1 Buchwald:2010:Ann-Surg:20485136 %A Buchwald, H %A Rudser, K D %A Williams, S E %A Michalek, V N %A Vagasky, J %A Connett, J E %D 2010 %J Ann Surg %K Lipids-POSCH %N 6 %P 1034-1040 %R 10.1097/SLA.0b013e3181deb4d0 %T Overall mortality, incremental life expectancy, and cause of death at 25 years in the program on the surgical control of the hyperlipidemias %U http://www.ncbi.nlm.nih.gov/pubmed/20485136 %V 251 %X OBJECTIVE: To present the longest follow-up report of any lipid-atherosclerosis intervention trial. SUMMARY OF BACKGROUND DATA: The Program on the Surgical Control of the Hyperlipidemias (POSCH), a secondary, clinical/arteriographic, randomized controlled trial, was the first lipid-atherosclerosis trial to demonstrate unequivocally that low density lipoprotein cholesterol reduction reduced the incidence of coronary heart disease death and myocardial infarction. METHODS: We report POSCH 25 years follow-up for overall mortality, specific cause of death, and certain subgroup analyses, as well as a prediction for increase in life expectancy derived from the POSCH database, supplemented by the 2006 National Death Index, 1989-2006. RESULTS: There were 838 patients randomized in POSCH (421 surgery, 417 control). At 25 years follow-up, the difference in the restricted mean survival and the logrank (Mantel-Haenszel) statistic was statistically significant, with survival probabilities of 0.57 (surgery) and 0.51 (controls). Cause of death data indicated a significant increase in cardiovascular deaths in the control group; cancer deaths were also greater in the control group but this was not significant. The most compelling subgroup analysis was a significant increase in survival, starting at 5 years after randomization, in the surgery group for patients with an ejection fraction > or = 50%, with relative probabilities of 0.61 (surgery) and 0.51 (control). The estimated incremental increase in life expectancy over more than 25 years of follow-up was 1.0 year overall and 1.7 years in the cohort with an ejection fraction > or = 50%. CONCLUSIONS: A 25-year mortality follow-up in POSCH shows statistically significant gains in overall survival, cardiovascular disease-free survival, and life expectancy in the surgery group compared with the control group.

@article{Buchwald:2010:Ann-Surg:20485136, abstract = {OBJECTIVE: To present the longest follow-up report of any lipid-atherosclerosis intervention trial. SUMMARY OF BACKGROUND DATA: The Program on the Surgical Control of the Hyperlipidemias (POSCH), a secondary, clinical/arteriographic, randomized controlled trial, was the first lipid-atherosclerosis trial to demonstrate unequivocally that low density lipoprotein cholesterol reduction reduced the incidence of coronary heart disease death and myocardial infarction. METHODS: We report POSCH 25 years follow-up for overall mortality, specific cause of death, and certain subgroup analyses, as well as a prediction for increase in life expectancy derived from the POSCH database, supplemented by the 2006 National Death Index, 1989-2006. RESULTS: There were 838 patients randomized in POSCH (421 surgery, 417 control). At 25 years follow-up, the difference in the restricted mean survival and the logrank (Mantel-Haenszel) statistic was statistically significant, with survival probabilities of 0.57 (surgery) and 0.51 (controls). Cause of death data indicated a significant increase in cardiovascular deaths in the control group; cancer deaths were also greater in the control group but this was not significant. The most compelling subgroup analysis was a significant increase in survival, starting at 5 years after randomization, in the surgery group for patients with an ejection fraction > or = 50%, with relative probabilities of 0.61 (surgery) and 0.51 (control). The estimated incremental increase in life expectancy over more than 25 years of follow-up was 1.0 year overall and 1.7 years in the cohort with an ejection fraction > or = 50%. CONCLUSIONS: A 25-year mortality follow-up in POSCH shows statistically significant gains in overall survival, cardiovascular disease-free survival, and life expectancy in the surgery group compared with the control group.}, added-at = {2010-07-03T09:23:59.000+0200}, author = {Buchwald, H and Rudser, K D and Williams, S E and Michalek, V N and Vagasky, J and Connett, J E}, biburl = {https://www.bibsonomy.org/bibtex/2e2f9649bcce0a9332eb5ae44e1cd97ed/freefattyacids}, description = {Overall mortality, incremental life expectancy, an... [Ann Surg. 2010] - PubMed result}, doi = {10.1097/SLA.0b013e3181deb4d0}, interhash = {8fcefcf860fbc0ffade1e9fdb160299c}, intrahash = {e2f9649bcce0a9332eb5ae44e1cd97ed}, journal = {Ann Surg}, keywords = {Lipids-POSCH}, month = jun, number = 6, pages = {1034-1040}, pmid = {20485136}, timestamp = {2010-07-03T09:23:59.000+0200}, title = {Overall mortality, incremental life expectancy, and cause of death at 25 years in the program on the surgical control of the hyperlipidemias}, url = {http://www.ncbi.nlm.nih.gov/pubmed/20485136}, volume = 251, year = 2010 }