The National Heart Centre (NHC) of Singapore has been invited to participate in a worldwide clinical research trial studying the treatment methods of heart failure.

The multicentre randomised trial, known as the Surgical Treatments for IsChemic Heart Failure (STICH) trial, will enroll approximately 2,800 patients from over 90 leading centres around the world, including Singapore.

The overall objective of this trial is to provide doctors with data to improve their clinical management strategies and thereby reduce the mortality and morbidity in patients with ischemic heart failure.

This is especially important since in recent years, heart failure has grown to become a worldwide problem with the mortality of heart failure patients even approaching 30% to 40% one year after diagnosis.

Said Consultant Cardiologist and Lead Cardiologist of the STICH trial Dr Bernard Kwok: "In Singapore, as estimated 60,000 Singaporeans suffer from heart failure, with the prevalence of heart failure being about 6-8% in individuals aged 65 and above.

"In addition, it has been found that 15% of heart attack survivors will develop heart failure within 5 years. This trial is therefore important in evaluating the various treatment options to nip the problem of heart failure in the bud, especially since coronary artery disease is the single most important cause of heart failure (over 50%)."

To study the effects of the various treatment options for heart failure, a total of 15 Singaporean heart failure patients will be enrolled in this trial. The patients will be randomly assigned to three groups according to their current health status and according to the treatment that would render them the most medical benefits.

The three groups will consist of:
  • Patients on medical therapy alone;
  • Patients on medical therapy with coronary artery bypass surgery;
  • And patients on medical therapy with coronary artery bypass surgery and surgical ventricular restoration (SAVER or Dor surgery).

These patients would then be scheduled to return to the National Heart Centre every four months for follow-up visits, tests and evaluations. In addition, these patients would also be followed-up by the STICH quality of life staff over the phone at the 4th, 12th, 24th and 36th month.

To give a talk on the comparison between the surgical and medical treatments of heart failure and to officially introduce the STICH trial to Singapore, Primary Investigator of the worldwide STICH trial and Cardiothoracic Surgeon of Duke Heart Centre Dr Robert Jones will be at the National Heart Centre today to give his talk.

Said Dr Jones: "As the enrolment of patients for the trial has so far been limited to Europe, America and Latin America, it is definitely exciting that we will be able to study the effects of the various treatments for heart failure in Asians with the inclusion of Singapore."

Although the STICH trial promises to be an advancement in the treatment of heart failure, Principal Investigator of the NHC STICH trial Dr Chua Yeow Leng cautions that this trial is not necessarily for all heart failure patients.

"As there are various stages of heart failure, the various treatment methods may not necessarily mean that one can forgo heart transplantation altogether. I would like to stress that the enrolment of patients for this trial at the National Heart Centre is strictly by invitation and that voluntary enrolment is most of the time not possible," he said.