STICH

Surgical Treatment for Ischemic Heart Failure — Extension Study (STICHES, 10-year follow-up)

Paciente / Población Intervención / Exposición Comparación Desenlace

In 1,212 patients with ischaemic cardiomyopathy (EF ≤ 35%) and CAD, coronary-artery bypass grafting plus medical therapy reduced 10-year all-cause mortality compared with medical therapy alone.

1212

Diseño

Open-label RCT with extended follow-up

Desenlace

All-cause mortality

Relevancia

ResultadoAt 10 years, 58.9% died with CABG plus medical therapy vs 66.1% with medical therapy alone (HR 0.84, 95% CI 0.73-0.97; P=0.02); CV death and death-or-CV-hospitalisation also reduced.

Velazquez EJ, et al. N Engl J Med. 2016;374(16):1511-1520. 10.1056/NEJMoa1602001

Discusión y crítica

Original 5-year STICH result was neutral for the primary endpoint; significant survival benefit emerged only with 10-year follow-up, with substantial crossover between arms. Established a durable survival benefit of CABG in ischaemic cardiomyopathy.