The World Post-STICH: Is This A ¡°Game Changer?¡± A Non-Invasive Cardiologist's Perspective¡ªRevascularization Is The Treatment of Choice Only In Patients Who Fail Medical Therapy

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• 作者：Chantal Elamm ; James C. Fang ; ^{james.fang@uhhospitals.org}
• 关键词：CABG ; coronary artery bypass graft ; CAD ; coronary artery disease ; CV ; cardiovascular ; EF ; ejection fraction ; HF ; heart failure ; LV ; left ventricular ; OMT ; optimal medical therapy ; STICH ; Surgical Treatment of Ischemic Cardiac Heart Failure
• 刊名：Progress in Cardiovascular Diseases
• 出版年：2013
• 出版时间：March-April, 2013
• 年：2013
• 卷：55
• 期：5
• 页码：466-469
• 全文大小：229 K

文摘

The optimal management for ischemic cardiomyopathy has been a clinical conundrum for years. Until the publication of the Surgical Treatment of Ischemic Cardiac Heart Failure (STICH) trial, recommendations have been primarily based upon expert opinion, retrospective literature, and clinical anecdotes. However, medical and device management have matured significantly in an era where surgical morbidity and mortality remain significant for coronary bypass grafting in the setting of severe left ventricular dysfunction. For the first time in years, there now exists a landmark prospective randomized clinical trial that addresses the role of coronary bypass surgery as an initial strategy for ischemic cardiomyopathy. Although many interpretations of STICH exist, the neutral results of STICH should reassure clinicians that a strategy of initiating and optimizing medical therapy and deferring surgical revascularization for ischemic cardiomyopathy in ¡°STICH-like patients¡± is effective, safe, and tested.