STICH

CABG plus optimal medical therapy

Optimal medical therapy alone

At a median follow-up of 56 months, all-cause mortality was 36% with CABG vs 41% with medical therapy (HR 0.86; 95% CI, 0.72-1.04; p=0.12).

At 10-year follow-up (STICHES), all-cause mortality was 58.9% with CABG vs 66.1% with medical therapy (HR 0.84; 95% CI, 0.73-0.97; p=0.02).

Cardiovascular mortality at 10 years was significantly lower with CABG (40.5% vs 49.3%; HR 0.79; p=0.006).

Death from any cause or hospitalization for cardiovascular causes was lower with CABG at both 5 and 10 years.

Adding surgical ventricular reconstruction (SVR) to CABG did not improve outcomes beyond CABG alone (SVR Hypothesis).

High crossover rate from medical therapy to CABG (17%) diluted the intention-to-treat analysis, particularly at the original 5-year endpoint.

Enrolled predominantly male patients (88%), limiting generalizability to women with ischemic heart failure.

Viability testing was not required for enrollment, and the viability substudy showed no interaction between viability status and treatment benefit.