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Taking people in GermanyNo phase

Compares two heart artery procedures in people with weak heart pumping

Compares bypass surgery with stents in adults with blocked heart arteries.

Key facts

Who runs it
Sunnybrook Health Sciences Centre
Where
Düsseldorf and Leipzig, GermanySee the 2 sitesAlso in 15 other countries, 44 sites
Trial code
Registry title
The Canadian CABG or PCI in Patients With Ischemic Cardiomyopathy Trial (STICH3C)
Status
Recruiting
People taking part
754 people, planned
Started
22 Jun 2023
Expected to end
Dec 2029
Type of study
Interventional, 2 groups
Treatments tested
  • Revascularization by PCI
  • Revascularization by CABG
Record updated
19 October 2026

Who can take part

AI summary

From the trial's eligibility criteria. Machine-read from the registry text on this page, so it can be wrong. The registry text below and the trial team decide who can take part.

The trial is looking for adults with heart failure from weak heart pumping and several narrowed heart arteries. It compares two ways of restoring blood flow: stents (PCI) and bypass surgery (CABG).

Age
Over 18 years
Sex
All sexes can join
Disease stage
Heart pumping strength (LVEF) of 40% or less. Triple vessel disease, or two-vessel disease involving the LAD or left main artery, with significant narrowing as defined in the record. The Heart Team must agree that both stents and bypass surgery are possible.
Earlier treatment
Heart failure medicine (GDMT) must have been started at least 1 month before, or in hospital before randomization for newly diagnosed cases. No stent procedure (PCI) in the past 12 months. No earlier heart surgery.

Main reasons for not taking part

  • Severe heart failure needing support less than 48 hours before randomization
  • Heart attack of the ST-elevation type less than 4 weeks ago
  • Severe valve disease or other condition needing surgery
  • Severe organ failure that cuts life expectancy to less than 5 years
  • Current pregnancy

The registry criteria, word for word

Show all 17 criteriaShow less

Who can take part

  • 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

Who cannot take part

  • 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

Where in Germany

Also in 15 other countries, 44 sites

  • University Hospital DüsseldorfDüsseldorf, GermanyContact: Alexander AssmannTaking people
  • Leipzig Heart CenterLeipzig, GermanyContact: Michael BorgerTaking people

About the trial

What the trial wants to find out

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 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.

The 2 groups in the trial

  • Revascularization by PCITreatment being tested

    Revascularization will be attempted on/for significant lesions in major coronary vessels/side branches as planned by the local Heart Team, with the general recommendation of stenotic/occluded vessels with diameter \>2.0 mm for PCI. The Heart Team consists of a minimum of one heart failure cardiologist, one interventional cardiologist and one cardiac surgeon.

  • Revascularization by CABGTreatment being tested

    Revascularization will be attempted on/for significant lesions in major coronary vessels/side branches as planned by the local Heart Team, with the general recommendation of stenotic/occluded vessels with diameter \>1.5 mm for CABG. The Heart Team consists of a minimum of one heart failure cardiologist, one interventional cardiologist and one cardiac surgeon

Questions to ask the study team

  1. How often do I need to come in, and for how long each time?
  2. Are travel costs paid?
  3. Can I keep my own doctor?
  4. What happens if I want to stop?

Contact the study team: see the registry record → Contacts and Locations

Print a page for my doctor

Data and sources

Registry record
Listed on ClinicalTrials.gov.
Official title
The Canadian CABG or PCI in Patients With Ischemic Cardiomyopathy Trial
Plain-language title
Compares two heart artery procedures in people with weak heart pumpingGenerated from the registry record. The registry title is the official one.
AI summary
From the trial's eligibility criteria. Read by machine on 12 November 2026.
Record updated
19 October 2026