For Ischemic Cardiomyopathy, Bypass Surgery May Be Better After All

Ten-year survival in the STICH extension study was significantly better with surgery than with medical therapy alone.

In the previously published STICH trial, 1212 patients (median age, 60) with coronary artery disease (CAD) that was amenable to coronary artery bypass grafting (CABG) and with left-ventricular ejection fractions (LVEFs) ≤35% were randomized to CABG plus medical therapy or medical therapy alone. No participants had ≥50% left-main coronary-artery stenosis or Canadian Cardiovascular Society class III–IV angina. During a median follow-up of 56 months, all-cause mortality (the primary outcome) was similar in the two groups, but the rate of death from cardiovascular causes was slightly lower with CABG (NEJM JW Cardiol May 2011 and N Engl J Med 2011; 364:1607). Now, an extension study (STICHES) lengthens the median follow-up to 9.8 years.

During th…

Reviewing Author

Howard C. Herrmann, MD

Disclosures

Consultant/Advisory BoardAffluent Medical; Artedrone; Caranx; Johnson & Johnson; Medtronic; Prolifagen; Wells Fargo

EquityMicrointerventional Devices, Inc.

RoyaltiesUniversity of Pennsylvania

Grant/Research SupportAbbott Vascular; Edwards Lifesciences; Johnson & Johnson; Medtronic

Editorial BoardsCatheterization and Cardiovascular Interventions; Journal of the American College of Cardiology; Circulation: Cardiovascular Interventions; JACC Cardiovascular Interventions; JACC Case Reports; JSCAI

Leadership Positions in Professional SocietiesHeart Valve Collaboratory (Scientific Committee Member, Chair of the Publications Committee)