Nevertheless, the need for subse- quent CABG is usually higher in those whose initial revas- cularization procedure was incomplete (compared with those with complete revascularization) after PCI.487 489 3.9.4. LV Systolic Dysfunction Several older studies and a meta-analysis of the data from these studies reported that patients with LV systolic dys- function (predominantly mild to moderate in severity) had better survival with CABG than with medical therapy alone.318,352 356 For patients with more severe LV systolic dysfunction, however, the evidence that CABG results in better survival compared with medical therapy is lacking. In the STICH (Surgical Treatment for Ischemic Heart Failure) 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 a number of 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. Although the primary out- come (death from any cause) was similar in the 2 treatment groups after an average of 5 years of follow-up, the data suggest the possibility that outcomes would differ if the follow-up were longer in duration; as a result, the study is being continued to provide follow-up for up to 10 years.371,372 Only very limited data comparing PCI with medical therapy in patients with LV systolic dysfunction are avail- able.356 In several ways, these data are suboptimal, in that many studies compared CABG with balloon angioplasty, many were retrospective, and many were based on cohort or registry data. 