This randomized multicenter trial compares coronary artery bypass grafting (CABG) with percutaneous coronary intervention (PCI) in 358 patients with ischemic left ventricular dysfunction and multivessel coronary disease. The study evaluates differences in survival, major cardiovascular events, and quality of life over 4 years, and contributes to the international STICH 3.0 collaboration assessing long-term outcomes.
Age ≥ 18 years
LVEF≤ 40%
Angina pectoris, CCS≥2 and/or hospitalization for ACS or heart failure within 1 year prior to randomization
Multivessel CAD (2-3 vessel-disease with coronary lesions >70% and involvement of proximal LAD, and/or LM stenosis of >50%). Target vessels are determined by the local Heart Time
ACS < 48 hours before randomization
Valvular/structural heart disease requiring intervention
Contra-indications to DAPT
Non-cardiac condition with life expectancy < 1 year
Parallel
CABG
Procedure/SurgeryCABG (coronary artery bypass grafting)
PCI
Procedure/SurgeryPCI (percutaneous coronary intervention)
Hierarchical composite of all-cause mortality, major adverse cardiovascular events, and heart failure hospitalizations
Outcomes will be analyzed using a hierarchical (win ratio / Finkelstein-Schoenfeld) approach to account for clinical severity
Individual components of the primary endpoint
Analysis of each component of the primary endpoint separately - all-cause mortality, non-procedural myocardial infarction, stroke, unplanned revascularization, and heart failure hospitalizations.
Cardiovascular mortality
Death due to cardiovascular causes
Periprocedural myocardial infarction
Myocardial infarction occurring during or within 30 days after the index revascularization procedure.
Target vessel and target lesion revascularization
Any repeat revascularization of the initially treated coronary vessel or lesion.
Click on the lead sponsor to view all of their trials.
University Medical Center Groningen
Lead sponsor
Dutch Heart Foundation
Collaborator
