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Heart surgery showdown: which procedure saves more lives?

NCT ID NCT05427370

Disease control Sponsor: Sunnybrook Health Sciences Centre Source: ClinicalTrials.gov ↗

What the study statuses mean

This study's is highlighted.

Recruitment status, easiest to join first

Recruiting now This study
This trial is taking on new participants right now.
Not yet recruiting
Registered, but not yet taking participants.
By invitation only
Not open to general applications. Only people the study team invites can take part.
Paused
Paused for now. It may or may not start again.
Ongoing
Running, but no longer taking on new participants.
Completed
The trial has finished. Results may not be published yet.
Stopped early
Stopped early, before it reached the end. That can be for many reasons, including safety.
Cancelled
Cancelled before anyone took part.

Expanded access (not trials)

Expanded access
Not a trial. This treatment can be requested outside a study, case by case, for people who qualify.
Expanded access (paused)
Not a trial. The treatment can normally be requested outside a study, but is unavailable right now.
Expanded access (ended)
Not a trial. The treatment could once be requested outside a study, but no longer can.
Approved
The treatment has been approved, so it is available normally rather than through this programme.

When the status isn't known

Details not published
The full record has not been published yet, so there is little to show here.
Status unknown
This status has not been confirmed recently, so it may be out of date.

First seen Jun 27, 2026 · Last updated Jun 27, 2026

Summary

This study compares two common heart procedures—bypass surgery (CABG) and stenting (PCI)—in 754 people with severe coronary artery disease and a weak heart pump. The goal is to see which approach better prevents death, stroke, heart attacks, or repeat procedures over 5 years. Participants must have multiple blocked arteries and a heart pumping ability of 40% or less.

This is an AI summary of the original study and may miss details. Read our disclaimer.

Study facts

What this study's own registry entry says, in plain language.

Phase

Not a phased trial

Phase numbers describe drug development. The registry uses this when they do not apply, as it does for trials of devices, procedures or behaviour changes, and for observational studies.

Participants

About 754 people

The number the study aims to enrol. It can still change while the study runs.

Started

Jun 2023

Expected to finish

Dec 2029

An estimate. End dates often move.

Lead sponsor

Other sponsor

The registry's catch-all category, for sponsors it does not file as a company, a government agency, or a research network.

Who can take part

This study's own entry requirements. Only the study team can say for certain whether you qualify.

Ages

18 years and older

Sex

Anyone

Healthy volunteers

Not accepted

This study is not open to healthy volunteers. The entry requirements below say who it is open to.

Show the full entry requirements

Copied word for word from the study's registry entry, so the wording is the study team's rather than ours.

Inclusion Criteria: 1. Age \>18 years; 2. LVEF ≤40% quantified by either echocardiography, SPECT ventriculography, or magnetic resonance within 2 months of randomization; 3. 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; 4. 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; 5. Signed informed consent. Exclusion Criteria: 1. 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; 2. Recent (\<4 weeks) ST-elevation MI; 3. Concomitant severe valvular disease or other condition such as left ventricular aneurysm requiring surgical repair or replacement; 4. Planned major concomitant surgical procedures (LAAO and AF ablation surgical procedures permitted); 5. Prior PCI within the past 12 months (to reduce restenosis events from prior PCIs contributing to the primary outcome); 6. Prior cardiac surgery; 7. Prohibitive bleeding risk mandating avoidance of dual antiplatelet therapy; 8. Circumstances likely to lead to poor treatment adherence; 9. Severe end-organ dysfunction (such as dialysis, liver failure, respiratory failure, cancer) that reduces life expectancy to less than 5 years; 10. Current pregnancy; 11. Patient not amenable to both CABG or PCI according to the Heart Team; 12. Takotsubo/Takotsubo Cardiomyopathy/Broken Heart Syndrome.

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Conditions

The condition(s) this trial relates to.

coronary artery disorder systolic heart failure Ventricular Dysfunction, Left

As listed by the trial registrant

The condition terms exactly as the trial's registrant entered them.

Coronary artery disease Heart failure, systolic

How to take part

Only the study team decides who joins. These are the ways to reach them.

  1. The places running it

    39 sites in 14 countries. The list below names each one and where it is.

  2. The official record

    ClinicalTrials.gov lists the study team's own contact details, including names and phone numbers. We don't republish those.

    Open the record ↗

  3. A doctor treating you

    A doctor who knows your case can contact a study site on your behalf, and can tell you whether this study is worth pursuing at all.

Contacts and locations

Locations

  • Al Nas Hospital

    RECRUITING

    Cairo, Qalyubia Governorate, Egypt

  • Cedars-Sinai

    RECRUITING

    Los Angeles, California, 90048, United States

  • Center Hospitalier Universitaire de Montreal

    RECRUITING

    Montreal, Quebec, , H2X OC1, Canada

  • Centro Hospitalar e Universitário Sao João

    RECRUITING

    Porto, 4200-319, Portugal

  • Clinical Hospital Dubrava

    RECRUITING

    Sušak, Zagreb, 10000, Croatia

  • Dedinje Cardiovascular Institute

    RECRUITING

    Belgrade, Serbia

  • European Hospital, Via Portuense

    RECRUITING

    Roma, RM, 00149, Italy

  • Fraser Health; Royal Columbian Hospital

    WITHDRAWN

    New Westminster, British Columbia, V3L3W7, Canada

  • G Kuppuswamy Naidu Memorial Hospital (GKNM)

    RECRUITING

    Palayam, Tamil Nadu, 641037, India

  • Hamilton General Hospital

    RECRUITING

    Hamilton, Ontario, L8L 2X2, Canada

  • Heart Institute, Medical School of the University of Sao Paulo_INCOR

    RECRUITING

    São Paulo, 05403-900, Brazil

  • Hospital Clinic de Barcelona (ICCV)

    RECRUITING

    Barcelona, L'Eixample, 08036, Spain

  • Hospital Clínico Universitario Virgen de la Arrixaca

    RECRUITING

    El Palmar, Murcia, 30120, Spain

  • Hospital Sacre-Coeur

    RECRUITING

    Montreal, Quebec, H4J 1C5, Canada

  • Hospital Universitario de Navarra

    RECRUITING

    Pamplona, 31008, Spain

  • Hospital del Vinalopó

    RECRUITING

    Alicante, Spain

  • Institut de Cardiologie Quebec (QC) - Laval

    RECRUITING

    Québec, Quebec, G1V 4G5, Canada

  • Instituto Mexicano del Seguro Social (IMSS)

    RECRUITING

    Mexico City, Mexico

  • Jilin Heart Hospital

    RECRUITING

    Jilin City, Changchun, 130117, China

  • John Hopkins Hospital

    RECRUITING

    Baltimore, Maryland, 21205, United States

  • Leipzig Heart Center

    RECRUITING

    Leipzig, 04289, Germany

  • London Health Sciences Center, University Hospital

    RECRUITING

    London, Ontario, N6A 5A5, Canada

  • Mackenzie Health Sciences Center

    RECRUITING

    Edmonton, Alberta, T6G 2B7, Canada

  • Mayo Clinic

    WITHDRAWN

    Rochester, Minnesota, 55905, United States

  • Medical University Bialystok

    RECRUITING

    Bialystok, 15-089, Poland

  • Medical University of Silesia

    ACTIVE_NOT_RECRUITING

    Katowice, Poland

  • Medical University of Vienna

    ACTIVE_NOT_RECRUITING

    Vienna, Austria

  • Montreal Heart Institute

    RECRUITING

    Montreal, Quebec, H1T 1C8, Canada

  • Ottawa Heart Institute

    RECRUITING

    Ottawa, Ontario, K1Y 4W7, Canada

  • Providence Health

    RECRUITING

    Vancouver, British Columbia, V6Z 1Y6, Canada

  • Queen Elizabeth II Hospital

    RECRUITING

    Halifax, Nova Scotia, B3H 2Y9, Canada

  • Ruijin Hospital, Shanghai Jiao Tong University School of Medicine

    RECRUITING

    Shanghai, 200031, China

  • Southlake Regional HC

    RECRUITING

    Newmarket, Ontario, L3Y 2P9, Canada

  • St. Michael's

    RECRUITING

    Toronto, Ontario, M5B 1W8, Canada

  • Sunnybrook Health Sciences Center

    RECRUITING

    Toronto, Ontario, M4N 3M5, Canada

  • The University of Manitoba and St. Boniface Hospital Inc.

    RECRUITING

    Winnipeg, Manitoba, R2H 2A6, Canada

  • Toronto General Hospital

    RECRUITING

    Toronto, Ontario, M5G 2N2, Canada

  • Unidade Local de Saude Lisboa Ocidental (ULSLO)

    RECRUITING

    Lisbon, 1350-410, Portugal

  • University Hospital Dusseldorf

    RECRUITING

    Düsseldorf, 40225, Germany

  • University Hospitals Cleveland Medical Center

    RECRUITING

    Cleveland, Ohio, 44106, United States

  • University of Calgary; Libin Cardiovascular Institute

    RECRUITING

    Calgary, Alberta, T2N 4Z6, Canada

  • UofL Health, Inc

    RECRUITING

    Louisville, Kentucky, 40202, United States

  • Yale University

    RECRUITING

    New Haven, Connecticut, 06510, United States

More trials for these conditions

Other studies related to the condition(s) this trial covers.