What evidence exists that CABG results in better survival compared with medical therapy for patients with more severe LV systolic dysfunction?
For patients with more severe LV systolic dysfunction, the evidence that CABG results in better survival compared with medical therapy is lacking. In the STICH trial of subjects with LVEF ,35% with or without viability testing, CABG and GDMT resulted in similar rates of survival (death from any cause, the study's primary outcome) after 5 years of follow-up. For several secondary outcomes at this time point, including 1) death from any cause or hospitalization for heart failure, 2) death from any cause or hospitalization for cardiovascular causes, 3) death from any cause or hospitalization for any cause, or 4) death from any cause or revascularization with PCI or CABG, CABG was superior to GDMT.