Interv Akut Kardiol. 2009;8(6):328-331

The initial outcomes of STICH Trial (Surgical Treatment of Ischemic Heart Failure Trial)

Růžena Jandová, Ivan Málek, Jan Pirk

Kardiocentrum IKEM, Praha

Surgical ventricular reconstruction (SVR) is a procedure designed to reduce left ventricular (LV) volume in patients with heart failure

caused by coronary artery disease. The aim of the study was the question whether SVR added to coronary-artery bypass grafting (CABG)

would decrease the rate of death or hospitalization for cardiac causes, as compared with CABG alone. 1,000 patients with (LV) ejection

fraction ≤ 35 %, coronary artery disease amenable to CABG, and dominant anterior LV dysfunction suitable to SVR were randomized to

CABG alone (n = 499) or CABG + SVR (n = 501). The median follow-up was 48 months. SVR reduced end-systolic volume index by 19 % as

compared with a reduction of 6 % with CABG alone (p < 0,001). Cardiac symptoms – NYHA and angina – and exercise tolerance improved to

a similar degree in both study groups, however there was no difference found in the primary outcome – i. e. the rate of death from any

cause and hospitalization for cardiac causes (58 % in patients after CABG + SVR and 59 % in patients after CABG alone).

Conclusions: Adding SVR to CABG reduced the LV volume, as compared with CABG alone. However, this anatomic change was not associated

with a greater improvement in symptoms or exercise tolerance or with a reduction in the rate of death or hospitalization for

cardiac causes.

Keywords: ischemic left ventricular dysfunction surgery, left ventricular reconstruction

Published: December 12, 2009  Show citation