STICH3C: Rationale and Study Protocol

• DOI: 10.1161/circinterventions.122.012527
• Publication Date: 2023-08-15T18:00:46Z
• Authors: Stephen E. Fremes; Guillaume Marquis...; Mario F.L. Gaudino; E. Marc Jolicoeur; Sylvain Bédard; Ruth Masterson Cr...; Marc Ruel; Dominique Vervoort; Harindra C. Wijey...; Michael E. Farkouh; Jean-Lucien Rouleau; Reena Karkhanis; Rakesh Arora; Michelle Graham; Jeff Healey; Jonathan Howlett; Alex Kiss; Dennis Ko; Doug Lee; Michael McGillion; Louise Sun; Richard Swartz; Pierre Voisine; Jeroen Bax; Filippo Crea; Torsten Doenst; Sanjit Jolly; Lars V. Koeber; Andre Lamy; Alexandra Lansky; Peter van der Meer; Milan Milojevic; Elmir Omerovic; Mark Petrie; Christopher Reid; Sigrid Sandner; Miguel Sousa-Uva; Eric Velazquez; Subodh Verma; Gregg W. Stone; John Spertus.
• Keywords: Stroke; Clinical endpoint; Ischemic Cardiomyopathy

BACKGROUND: Coronary artery bypass grafting (CABG) is the recommended mode of revascularization in patients with ischemic left ventricular dysfunction (iLVSD) and multivessel disease. However, contemporary percutaneous coronary intervention (PCI) outcomes have improved integration novel technologies refinement strategies, PCI often used clinical practice this population. There a lack evidence from randomized trials comparing state-of-the-art versus CABG for treatment iLVSD This was impetus STICH3C trial (Canadian or Patients With Ischemic Cardiomyopathy), described here. METHODS: The prospective, unblinded, international, multicenter an expected sample size 754 participants ≈45 centers. multivessel/left main disease ejection fraction ≤40% considered by local Heart Team appropriate amenable to both modes will be 1:1 ratio CABG. RESULTS: primary end point composite death any cause, stroke, spontaneous myocardial infarction, urgent repeat revascularization, heart failure readmission, summarized as time-to-event outcome. key hierarchical time frequency hospitalizations failure. safety outcome major adverse events. Disease-specific quality-of-life health economics measures compared between groups. Participants followed median 5 years, minimum follow-up 4 years. CONCLUSIONS: directly inform patients, clinicians, international guidelines about efficacy iLVSD. results provide broad evidence, including events, status, economic assessments, guide care severe REGISTRATION: URL: https://clinicaltrials.gov/ ; Unique identifier: NCT05427370.