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Microinjection for Transgenesis and Genome Editing in Threespine Sticklebacks

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STICH3C: Rationale and Study Protocol.

Stephen E Fremes¹, Guillaume Marquis-Gravel², Mario F L Gaudino³

¹Schulich Heart Centre, Sunnybrook Health Sciences Centre, University of Toronto, Ontario, Canada (S.E.F., D.V., H.C.W.).

Circulation. Cardiovascular Interventions

|August 15, 2023

Summary

This summary is machine-generated.

The STICH3C trial compares coronary artery bypass grafting (CABG) to percutaneous coronary intervention (PCI) for patients with ischemic left ventricular dysfunction and multivessel disease. Results will guide treatment decisions for severe coronary artery disease.

Keywords:

coronary artery bypass coronary disease ischemic heart disease percutaneous coronary intervention ventricular dysfunction, left

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Area of Science:

Cardiovascular Medicine
Interventional Cardiology
Cardiac Surgery

Background:

Coronary artery bypass grafting (CABG) is recommended for ischemic left ventricular dysfunction (iLVSD) with multivessel disease.
Percutaneous coronary intervention (PCI) use is increasing in this population due to technological advancements.
Limited randomized trial data exists comparing contemporary PCI and CABG for iLVSD.

Purpose of the Study:

To compare the efficacy and safety of state-of-the-art PCI versus CABG in patients with iLVSD and multivessel coronary artery disease.
To provide evidence for clinical practice and guideline development.
To assess clinical events, health status, and economic outcomes.

Main Methods:

Prospective, unblinded, international, multicenter trial (STICH3C).
Randomization of 754 patients with iLVSD (LVEF ≤40%) and multivessel/left main disease to PCI or CABG (1:1 ratio).
Primary endpoint: composite of death, stroke, myocardial infarction, urgent revascularization, or heart failure readmission.

Main Results:

Primary endpoint data collection is ongoing.
Key hierarchical endpoint: time to death and heart failure hospitalizations.
Key safety outcome: composite of major adverse events.

Conclusions:

STICH3C trial results will inform patient care, clinical practice, and international guidelines.
The study will offer novel evidence on CABG vs. PCI for iLVSD.
Findings will guide management of iLVSD with severe coronary artery disease.