1 / 3

STICH Substudy

STICH Substudy. Influence of Myocardial Viability on Outcome in Patients with CAD and LV Function Undergoing Medical Therapy with and without Surgical Revascularization: Results of the STICH Trial. Objective

gotzon
Download Presentation

STICH Substudy

An Image/Link below is provided (as is) to download presentation Download Policy: Content on the Website is provided to you AS IS for your information and personal use and may not be sold / licensed / shared on other websites without getting consent from its author. Content is provided to you AS IS for your information and personal use only. Download presentation by click this link. While downloading, if for some reason you are not able to download a presentation, the publisher may have deleted the file from their server. During download, if you can't get a presentation, the file might be deleted by the publisher.

E N D

Presentation Transcript

  1. STICH Substudy Influence of Myocardial Viability on Outcome in Patients with CAD and LV Function Undergoing Medical Therapy with and without Surgical Revascularization: Results of the STICH Trial Objective • To determine if myocardial viability confers a survival advantage in CABG patients with CAD and LV function Study Design • Multicenter, nonblinded, randomized trial • Substudy of the STICH Trial • 601 patients with CAD and LV dysfunction enrolled in the STICH trial • Use of single-photon-emission computed tomography (SPECT) • Dobutamine echocardiography, or both to assess myocardial viability

  2. STICH Substudy Results • 37% of patients with a viable myocardium died (HR, 0.64; 95% CI, 0.48 to 0.86; p=0.003); however, myocardial viability was not significantly related to mortality (p=0.21) • 51% of patients without a viable myocardium died • The secondary endpoint of cardiovascular-related mortality was significantly lower in patients with viability on univariate analysis (5-year mortality 29% vs 43%; p=0.003) but not on multivariable analysis (p=0.34) • The secondary combined endpoint of mortality plus cardiovascular-related hospitalization occurred less frequently in patients with viability (5-year events 63% vs 82%), even after adjustment (p<0.001)

  3. STICH Substudy Conclusions • Findings suggest that assessment of myocardial viability does not provide incremental independent information in identifying patients with CAD and LV dysfunction who will have the greatest survival benefit from adding CABG • Assessment of myocardial viability should not be the sole deciding factor in selecting the best therapy for patients in this population Study Limitations • Lack of randomization for viability testing • the small number of patients • small proportion of patients who were judged not to have substantial viability

More Related