Surgical Versus Percutaneous Revascularization in Patients With Reduced Left Ventricular Function (STICH 3.0-NL)

Summary

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.

Eligibility

Inclusion Criteria:

* 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
* Clinical and angiographical characteristics suitable for isolated coronary revascularization both by CABG or PCI according to the judgment of the local Heart Team
* Written informed consent

Exclusion Criteria:

* ACS \< 48 hours before randomization
* Valvular/structural heart disease requiring intervention
* Contra-indications to DAPT
* Non-cardiac condition with life expectancy \< 1 year
* Previous CABG
* Decompensated HF at the time of inclusion

Conditions9

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