Key result
Percutaneous coronary intervention did not significantly improve MACE or decrease admission due to ACS or heart failure compared to medical treatment alone in patients with HFrEF.
Why the study?
The value of PCI over medical therapy in heart failure patients with angina, multivessel CAD, and intermediate SYNTAX score, as well as the short-term outcomes of complete revascularization, remains questionable.
Does percutaneous coronary intervention reduce MACE or admission due to ACS or heart failure in patients with HFrEF and intermediate SYNTAX score compared to medical therapy alone?
Cohort (n=152)
Does percutaneous coronary intervention reduce MACE or admission due to ACS or heart failure in patients with HFrEF and intermediate SYNTAX score compared to medical therapy alone?
In patients with HFrEF and intermediate SYNTAX score, PCI did not significantly improve MACE or reduce admissions compared to medical therapy alone, though it did improve ischemic mitral regurgitation.
PCI offers no clear benefit over medical therapy in HFrEF with intermediate SYNTAX; leaves open need for larger trials.
Background: Ischemic heart disease is the most frequent cause of heart failure and reduced ejection fraction. The value of PCI over medical therapy in heart failure patient with angina, multi-vessel coronary artery disease and intermediate SYNTAX score is still questionable. The same also applied to the short-term outcomes of completeness of revascularization.Methods: we included 152 patients with heart failure and reduced EF with two or more vessel coronary artery disease. Patients were divided into 2 groups:The first group (PCI group): 100 patients in whom revascularization by PCI was done. The second group (medical therapy group): 52 patients who received medical treatment alone. 65% of them were males. No significant difference regarding baseline SYNTAX score between both groups with a bit higher median in PCI group (28 versus 26.5 in the medical therapy group).Results No significant difference between both groups regarding the primary endpoint. EF was improved in both groups with absolute increase in the PCI group 13% i.e 40% of the baseline EF. PCI improved the ischemic mitral regurgitation significantly. Regarding secondary outcomes, both groups were improved as for CCS with no significant benefit regarding PCI over medical treatment (p=0.644).Conclusion In patients with heart failure with reduced EF and intermediate SYNTAX score, PCI , in comparison to medical treatment alone, did not improve MACE or decrease admission due to ACS or heart failure.
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Sanhoury et al. (2026) conducted a cohort in Heart failure with reduced ejection fraction and multi-vessel coronary artery disease (n=152). Percutaneous coronary intervention (PCI) vs. Medical treatment alone was evaluated on MACE or admission due to ACS or heart failure. Percutaneous coronary intervention did not significantly improve MACE or decrease admission due to ACS or heart failure compared to medical treatment alone in patients with HFrEF.
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