Surgical Treatment for Ischaemic Heart Failure Trial (STICH)

ISRCTN ISRCTN09382700
DOI https://doi.org/10.1186/ISRCTN09382700
ClinicalTrials.gov number NCT00023595
Secondary identifying numbers 5148
Submission date
07/07/2010
Registration date
07/07/2010
Last edited
17/07/2014
Recruitment status
No longer recruiting
Overall study status
Completed
Condition category
Circulatory System
Prospectively registered
Protocol
Statistical analysis plan
Results
Individual participant data

Plain English summary of protocol

Not provided at time of registration

Study website

Contact information

Mr Mike Lammiman
Scientific

Department of Cardiology
Castle Road
Cottingham
HU16 5JQ
United Kingdom

Email mike.lammiman@hey.nhs.uk

Study information

Study designMulticentre randomised interventional treatment trial
Primary study designInterventional
Secondary study designRandomised controlled trial
Study setting(s)Hospital
Study typeTreatment
Participant information sheet Not available in web format, please use the contact details below to request a patient information sheet
Scientific titleSurgical Treatment for Ischaemic Heart Failure Trial (STICH): a multicentre randomised interventional treatment trial
Study objectivesNo randomised trial has ever directly compared long-term benefits of surgical and medical treatment of patients with ischaemic heart failure (HF). Along the broad spectrum of severity of ischaemic HF, specific clinical information, such as severe angina or left main coronary artery stenosis, may clearly indicate the need for surgical therapy for some patients.

However, a large number of patients fall into a gray zone without clear evidence for benefit from either medical or surgical therapy. For these patients, evidence supporting choice between therapies was never strong and has only been confused by recent studies showing improved outcomes with both therapies.

Patients for whom equipoise of anticipated benefit now exists between modern medical and surgical therapy represent the broad population who are appropriate candidates for a randomised trial to provide the context for assessing the value of two therapeutic strategies:
1. Medication (MED) alone
2. MED and coronary artery bypass grafting (CABG)

The study is also being run in the USA and includes surgical ventricular reconstruction as a treatment option in those sites only.

As of 13/07/2010 the study is seeking a protocol amendment to extend follow-up for another 9 years.
Ethics approval(s)Hull and East Riding REC, 04/08/2005, ref: 05/MRE00/51
Health condition(s) or problem(s) studiedTopic: Cardiovascular; Subtopic: Cardiovascular (all Subtopics); Disease: Cardiovascular
Intervention1. Optical medication (for heart failure according to National Institute for Clinical Excellence [NICE] guidelines)
2. CABG and optimal medication

Total duration of treatment: up to 6 years maximum
Follow-up length: 36 months
Intervention typeOther
Primary outcome measureCABG combined with MED compared to MED alone, measured up to 6 years.
Secondary outcome measuresMeasured up to 6 years:
1. Cardiac magnetic resonance (CMR) of left ventricle (LV) shape, size and function for predicting the benefit of a specific treatment strategy
2. Nuclear cardiology and/or echocardiography testing of myocardial ischaemia
Overall study start date22/12/2005
Completion date30/05/2007

Eligibility

Participant type(s)Patient
Age groupAdult
Lower age limit18 Years
SexBoth
Target number of participantsPlanned sample size: 2800
Key inclusion criteria1. Men
2. Women who are not of childbearing potential
3. Aged 18 years or above
4. Who have a left ventricular ejection fraction (LVEF) less than 0.35 measured by cardiac magnetic resonance (CMR) ventriculogram, gated single photon emission computed tomography (SPECT) ventriculogram, echocardiography, or contrast ventriculogram within three months of trial entry
5. Who have coronary artery disease suitable for revascularisation
Key exclusion criteria1. Failure to provide informed consent
2. Aortic valvular heart disease clearly indicating the need for aortic valve repair or replacement
3. Cardiogenic shock (within 72 hours of randomization) as defined by the need for intra-aortic balloon support or the requirement for intravenous inotropic support
4. Plan for percutaneous intervention of coronary artery disease
5. Recent acute myocardial infarction judged to be an important cause of left ventricular dysfunction
6. History of more than one prior coronary bypass operation
7. Non-cardiac illness with a life expectancy of less than 3 years
8. Non-cardiac illness imposing substantial operative mortality
9. Conditions/circumstances likely to lead to poor treatment adherence (e.g., history of poor compliance, alcohol or drug dependency, psychiatric illness, no fixed abode)
10. Previous heart, kidney, liver, or lung transplantation
11. Current participation in another clinical trial in which a patient is taking an investigational drug or receiving an investigational medical device

MED Therapy Eligibility Criteria:
12. Absence of left main coronary artery disease as defined by an intraluminal stenosis of 50% or greater
13. Absence of Canadian Class III angina or greater (angina markedly limiting ordinary activity)
Date of first enrolment22/12/2005
Date of final enrolment30/05/2007

Locations

Countries of recruitment

  • England
  • United Kingdom
  • United States of America

Study participating centre

Department of Cardiology
Cottingham
HU16 5JQ
United Kingdom

Sponsor information

Duke University (USA)
University/education

School of Medicine
Durham
NC 27710
United States of America

Website http://www.duke.edu/
ROR logo "ROR" https://ror.org/00py81415

Funders

Funder type

Government

National Institute for Health Research (NIHR) (UK)
Government organisation / National government
Alternative name(s)
National Institute for Health Research, NIHR Research, NIHRresearch, NIHR - National Institute for Health Research, NIHR (The National Institute for Health and Care Research), NIHR
Location
United Kingdom
National Institutes of Health (NIH) (USA) - National Heart, Blood and Lung Institute (ref: 5 U01 HL069015-4)

No information available

Results and Publications

Intention to publish date
Individual participant data (IPD) Intention to shareNo
IPD sharing plan summaryNot provided at time of registration
Publication and dissemination planNot provided at time of registration
IPD sharing plan

Study outputs

Output type Details Date created Date added Peer reviewed? Patient-facing?
Protocol article protocol 01/12/2007 Yes No
Results article results 23/04/2009 Yes No
Results article results 01/05/2009 Yes No
Results article results 03/08/2010 Yes No
Results article results 03/08/2010 Yes No
Results article results 28/04/2011 Yes No
Results article results 28/04/2011 Yes No
Results article results 01/03/2012 Yes No
Results article results 29/05/2012 Yes No
Results article results 01/01/2013 Yes No
Results article results 01/05/2013 Yes No
Results article results 07/05/2013 Yes No
Results article results 01/10/2013 Yes No
Results article results 01/10/2013 Yes No
Results article results 01/11/2013 Yes No
Results article results 01/12/2013 Yes No
Results article results 01/08/2014 Yes No