Compares two heart artery procedures in people with weak heart pumping
Compares bypass surgery with stents in adults with blocked heart arteries.
Plain-language title generated from the registry record
Registry title: The Canadian CABG or PCI in Patients With Ischemic Cardiomyopathy Trial (STICH3C)
Key facts
- Where
- Calgary, Edmonton, Halifax, Hamilton, London, Montreal, New Westminster, Newmarket, Ottawa, Québec, Toronto, Vancouver, and Winnipeg, CanadaSee the 18 sites
Where in Canada
- University of Calgary; Libin Cardiovascular InstituteCalgary, CanadaTaking people
- Mackenzie Health Sciences CenterEdmonton, CanadaTaking people
- Queen Elizabeth II HospitalHalifax, CanadaTaking people
- Hamilton General HospitalHamilton, CanadaTaking people
- London Health Sciences Center, University HospitalLondon, CanadaTaking people
- Center Hospitalier Universitaire de MontrealMontreal, CanadaTaking people
- Hospital Sacre-CoeurMontreal, CanadaTaking people
- Montreal Heart InstituteMontreal, CanadaTaking people
- Jewish General HospitalMontreal, CanadaNo longer taking part
- Fraser Health; Royal Columbian HospitalNew Westminster, CanadaNo longer taking part
- Southlake Regional HCNewmarket, CanadaTaking people
- Ottawa Heart InstituteOttawa, CanadaTaking people
- Institut de Cardiologie Quebec (QC) - LavalQuébec, CanadaTaking people
- St. Michael'sToronto, CanadaTaking people
- Sunnybrook Health Sciences CenterToronto, CanadaTaking people
- Toronto General HospitalToronto, CanadaTaking people
- Providence HealthVancouver, CanadaTaking people
- The University of Manitoba and St. Boniface Hospital Inc.Winnipeg, CanadaTaking people
Questions to ask the study team
- How often do I need to come in, and for how long each time?
- Are travel costs paid?
- Can I keep my own doctor?
- What happens if I want to stop?
Trial details
- Who runs it
- Sunnybrook Health Sciences Centre
- Trial code
- NCT05427370
- Record updated
- 19 October 2026
- Original description
The Canadian CABG or PCI in Patients With Ischemic Cardiomyopathy (STICH3C) trial is a prospective, unblinded, international multi-center randomized trial of 754 subjects enrolled in approximately 45 centers comparing revascularization by percutaneous coronary intervention (PCI) vs. coronary artery bypass grafting (CABG) in patients with multivessel/left main (LM) coronary artery disease (CAD) and reduced left ventricular ejection fraction (LVEF).Read full original descriptionShow less
The Canadian CABG or PCI in Patients With Ischemic Cardiomyopathy Trial
The Canadian CABG or PCI in Patients With Ischemic Cardiomyopathy (STICH3C) trial is a prospective, unblinded, international multi-center randomized trial of 754 subjects enrolled in approximately 45 centers comparing revascularization by percutaneous coronary intervention (PCI) vs. coronary artery bypass grafting (CABG) in patients with multivessel/left main (LM) coronary artery disease (CAD) and reduced left ventricular ejection fraction (LVEF).
The primary objective is to determine whether CABG compared to PCI is associated with a reduction in all-cause death, stroke, spontaneous myocardial infarction (MI), urgent repeat revascularization (RR), or heart failure (HF) readmission over a median follow-up of 5 years in patients with multivessel/LM CAD and ischemic left ventricular dysfunction (iLVSD).
Eligible patients are considered by the local Heart Team appropriate and amenable for non-emergent revascularization by both modes of revascularization.
The secondary objectives are to describe the early risks of both procedures, and a comprehensive set of patient-reported outcomes longitudinally.
Inclusion: Age >18 years; LVEF ≤40% quantified by either echocardiography, SPECT ventriculography, or magnetic resonance within 2 months of randomization; Prognostically important multivessel CAD (triple vessel CAD or double vessel disease including the left anterior descending (LAD) or LM). Significant coronary stenosis is defined as ≥ 70% based on coronary angiography, and/or fractional flow reserve (FFR) ≤0.80 or instantaneous wave-free ratio (iFR) ≤0.89. For LM disease, significant coronary stenosis is defined as >50% based on coronary angiography, intravascular ultrasound (IVUS) minimal luminal area (MLA) ≤6.0 mm2 (<4.5 mm2 Asian descent), or equivalent optical coherence tomography (OCT) measurements; The institutional Heart Team agrees that guideline-directed medical therapy (GDMT) has been initiated for ≥1 month in prevalent and newly diagnosed cases. In patients hospitalized with newly diagnosed iLVSD (with or without acute coronary syndrome (ACS)) requiring revascularization before discharge, GDMT needs to be initiated, when possible in-hospital before randomization, with the expectation that it will be titrated to maximally tolerated doses after revascularization; Signed informed consent.
Exclusion: Decompensated HF requiring inotropic/adrenergic support, invasive or non-invasive ventilation or intra-aortic balloon pump/ventricular assist device therapy less than 48 hours prior to randomization; Concomitant severe valvular disease or other condition such as left ventricular aneurysm requiring surgical repair or replacement; Planned major concomitant surgical procedures (LAAO and AF ablation surgical procedures permitted); Prior PCI within the past 12 months (to reduce restenosis events from prior PCIs contributing to the primary outcome); Prior cardiac surgery; Prohibitive bleeding risk mandating avoidance of dual antiplatelet therapy; Severe end-organ dysfunction (such as dialysis, liver failure, respiratory failure, cancer) that reduces life expectancy to less than 5 years; Patient not amenable to both CABG or PCI according to the Heart Team; Takotsubo/Takotsubo Cardiomyopathy/Broken Heart Syndrome; Recent (<4 weeks) ST-elevation MI; Circumstances likely to lead to poor treatment adherence; Current pregnancy.