STICH-3.0 International Trial Consortium

Inclusion Criteria: * Age \>18 years * LVEF ≤40% * Extensive coronary artery disease (typically defined as a British Cardiovascular Intervention Society jeopardy score of ≥6, on a scale from 0 to 12, with higher scores indicating greater extent of disease). Exclusion Criteria: * Decompensated heart failure 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; * Valvular heart disease or any other cardiac conditions (e.g. LV aneurysm) indicating the need for surgical repair/replacement; * Prohibitive bleeding risk or clinical scenario mandating avoidance of long-term dual antiplatelet therapy; * Pregnancy; * Circumstances likely to lead to poor treatment adherence; * STEMI within 72 hours; * PCI within 3 months.