Coronary revascularization, especially CABG, may benefit HFrEF patients with ischemic heart disease, but PCI benefits are inconsistent, needing further trials.
Does coronary revascularization improve outcomes in patients with ischemic heart disease and HFrEF compared to optimal medical treatment?
This review highlights the uncertain benefit of coronary revascularization, particularly PCI, in patients with ischemic HFrEF on modern optimal medical therapy, emphasizing the need for contemporary clinical trials.
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Heart failure with reduced ejection fraction (HFrEF) is a major contributor to cardiovascular morbidity and mortality, with ischemic heart disease as the leading etiology. Despite advances in optimal medical treatment (OMT), the additional benefit of coronary revascularization in this population remains uncertain. While some studies describe a potential benefit in revascularization—particularly with coronary artery bypass grafting (CABG)—this benefit has not been consistently observed with percutaneous coronary intervention (PCI). Moreover, in this context, the role of myocardial hibernation has been called into question. Additionally, recent advances in the medical management of heart failure complicate the current interpretation of previous studies and underscore the need for new clinical trials. This review synthesizes the current evidence on the potential benefits of coronary revascularization in patients with heart failure with reduced ejection fraction (HFrEF).
Lacalle et al. (Wed,) reported a other. Coronary revascularization, especially CABG, may benefit HFrEF patients with ischemic heart disease, but PCI benefits are inconsistent, needing further trials.