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Jones RH, Velazquez EJ, Michler RE, Sopko G, Oh JK, O'Connor CM, Hill JA, Menicanti L, Sadowski Z, Desvigne-Nickens P, Rouleau JL, Lee KL; STICH Hypothesis 2 Investigators.
N Engl J Med. 2009 Apr 23;360(17):1705-17.
The STICH trial tested the hypothesis about the superiority in coronary-artery bypass grafting ( CABG ) combined with left ventricular reconstruction compared with CABG alone. The study comprised 1000 patients with symptomatic significant left ventricular systolic dysfunction (LVEF ≤35%), coronary artery disease, dominant anterior akinesia or dyskinesia of left ventricle wall and qualification for surgery revascularization. During 48-month follow-up surgical ventricular reconstruction reduced the left ventricular end systolic volume by 19% versus a 6% reduction in a group with CABG alone, but it was associated with any change in neither exercise tolerance nor outcome (defined as all-cause mortality and hospitalization due to cardiac reasons).
The STICH trial tested the very important hypothesis regarding the beneficial effects of surgical ventricular reconstruction added to standard coronary artery by-pass grafting in patients with ischaemic chronic heart failure. Nevertheless, the results from this large multicenter trial that recruited in total 1000 patients failed to show any additional clinical benefits of such an intervention in the context of improvement of exercise capacity or prognosis. Additional post-hoc analyses are underway in order to test whether specific subgroups of patients could benefit from surgical ventricular reconstruction.
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