Trial reportJournal of the American College of Cardiology2013
Inducible myocardial ischemia and outcomes in patients with coronary artery disease and left ventricular dysfunction.
Trial report in Journal of the American College of Cardiology, 2013. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00023595 (Surgical Treatment for Ischemic Heart Failure), which is not on this map. Cited by 69 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Surgical Treatment for Ischemic Heart Failure (STICH)
Who cites it
69 citing papers in PubMed, 1 synthesis or guideline pooled it, 197 citations in OpenAlex.
- Assessment of Myocardial Viability in Ischemic Cardiomyopathy With Reduced Left Ventricular Function Undergoing Coronary Artery Bypass Grafting.Clinical cardiology · 2024Pooled it
- Importance of angina in patients with coronary disease, heart failure, and left ventricular systolic dysfunction: insights from STICH.Journal of the American College of Cardiology · 2015Trial
- Relationship between myocardial perfusion abnormalities and contractile impairment in anginal patients.Journal of nuclear cardiology : official publication of the American Society of Nuclear Cardiology · 2014Trial
- Extent of coronary and myocardial disease and benefit from surgical revascularization in ischemic LV dysfunction [Corrected].Journal of the American College of Cardiology · 2014Trial
- Trial
- Whole blood epigenomic and transcriptomic characterization identifies vulnerable molecular subtypes of chronic coronary disease.Nature communications · 2026Article
- Optimizing protected PCI strategies in the setting of chronic kidney disease and advanced coronary artery disease: a clinical case-based discussion.European heart journal supplements : journal of the European Society of Cardiology · 2026Article
- Outcomes and Predictors of In-Hospital Mortality After Isolated Coronary Artery Bypass Grafting in Patients with Severe Ischemic Cardiomyopathy: A Single-Centre Retrospective Analysis.Medical sciences (Basel, Switzerland) · 2026Article
- Mechanical Circulatory Support on Coronary Artery Bypass Grafting for Advanced Ischemic Cardiomyopathy: State of the Art.Medicina (Kaunas, Lithuania) · 2026Review
- Real-world effectiveness of early revascularization in stable coronary artery disease with moderate or severe ischemia.American heart journal plus : cardiology research and practice · 2025Article
- Article
- The Effect of Coronary Artery Bypass Graft Surgery on Contractile Function and Symptoms in Patients with Left Ventricular Dysfunction.Arquivos brasileiros de cardiologia · 2025Article
- Optimizing Revascularization in Ischemic Cardiomyopathy: Comparative Evidence on the Benefits and Indications of CABG and PCI.Life (Basel, Switzerland) · 2025Review
- Prognostic impact of inducible ischaemia in ischaemic left ventricular dysfunction: the REVIVED-BCIS2 trial.European heart journal · 2025Article
- Current indications and surgical strategies for myocardial revascularization in patients with left ventricular dysfunction: a scoping review.Journal of cardiothoracic surgery · 2024Article
- Outcomes of Percutaneous Revascularization in Severe Ischemic Left Ventricular Dysfunction.Current cardiology reports · 2024Review
- Invasive Treatment of Left Main Coronary Artery Disease: From Anatomical Features to Mechanistic Differences.Current cardiology reviews · 2024Review
- The Evolving Paradigm of Revascularization in Ischemic Cardiomyopathy: from Recovery of Systolic Function to Protection Against Future Ischemic Events.Current cardiology reports · 2023Review
- Understanding the role of coronary artery revascularization in patients with left ventricular dysfunction and multivessel disease.Heart failure reviews · 2023Review
- Why percutaneous revascularisation might not reduce the risk of myocardial infarction and mortality in patients with stable CAD?Open heart · 2023Review
9 more citing papers are in PubMed but not listed here.
Corrections and comments
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Authors and funding
12 authors at 6 institutions in 2 countries.
Funding
Abstract
objectivesThe study objectives were to test the hypotheses that ischemia during stress testing has prognostic value and identifies those patients with coronary artery disease (CAD) with left ventricular (LV) dysfunction who derive the greatest benefit from coronary artery bypass grafting (CABG) compared with medical therapy.
backgroundThe clinical significance of stress-induced ischemia in patients with CAD and moderately to severely reduced LV ejection fraction (EF) is largely unknown.
methodsThe STICH (Surgical Treatment for IsChemic Heart Failure) trial randomized patients with CAD and EF ≤35% to CABG or medical therapy. In the current study, we assessed the outcomes of those STICH patients who underwent a radionuclide (RN) stress test or a dobutamine stress echocardiogram (DSE). A test was considered positive for ischemia by RN testing if the summed difference score (difference in tracer activity between stress and rest) was ≥4 or if ≥2 of 16 segments were ischemic during DSE. Clinical endpoints were assessed by intention to treat during a median follow-up of 56 months.
resultsOf the 399 study patients (51 women, mean EF 26 ± 8%), 197 were randomized to CABG and 202 were randomized to medical therapy. Myocardial ischemia was induced during stress testing in 256 patients (64% of the study population). Patients with and without ischemia were similar in age, multivessel CAD, previous myocardial infarction, LV EF, LV volumes, and treatment allocation (all p = NS). There was no difference between patients with and without ischemia in all-cause mortality (hazard ratio: 1.08; 95% confidence interval: 0.77 to 1.50; p = 0.66), cardiovascular mortality, or all-cause mortality plus cardiovascular hospitalization. There was no interaction between ischemia and treatment for any clinical endpoint.
conclusionsIn CAD with severe LV dysfunction, inducible myocardial ischemia does not identify patients with worse prognosis or those with greater benefit from CABG over optimal medical therapy. (Comparison of Surgical and Medical Treatment for Congestive Heart Failure and Coronary Artery Disease [STICH]; NCT00023595).
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.