Heart failure & cardiomyopathies

Coronary Revascularization for Heart Failure with Coronary Artery Disease: A Systematic Review and Meta-Analysis of Randomized Trials

Eur J Heart FailPublished Systematic review and meta-analysis of randomised trials

Pooled result · All-cause mortalityResult — go to the resultHazard ratio 0.88 95% CI 0.79–0.99

Authors' conclusion

For patients with chronic HF and CAD enrolled in RCTs, the effect of coronary revascularization on all-cause mortality was statistically significant but neither substantial (HR 0.88) nor robust (upper 95% CI close to 1.0).

Study context

Population
Chronic heart failure (HF) due to coronary artery disease (CAD) (most aged <65 years; 85% men; 67% with LVEF ≤35%)
Participants
2,842 participants5 randomized controlled trials (RCTs)
Comparison
Coronary revascularization vs medical therapy alone
Outcome
All-cause mortality
Methodological detailsRCTs were not blinded
  • RCTs were not blinded

Pooled result

As reported in the abstract

Hazard ratio

0.88

95% CI 0.79–0.99

P = 0.0278

Coronary revascularizationvs Medical therapy alone
HR 0.88 (95% CI 0.79–0.99); P = 0.0278

Further pooled results

OutcomeHR (95% CI)P value
CV mortality0.80 (0.70–0.93)P = 0.0024
HF hospitalization or all-cause mortality0.87 (0.74–1.01)P = 0.0728

CABG vs PCI

Insufficient data to show whether effects of CABG or PCI were similar or differed

Original publication

Coronary Revascularization for Heart Failure with Coronary Artery Disease: A Systematic Review and Meta-Analysis of Randomized Trials. Eur J Heart Fail. Published 29 June 2023. doi:10.1002/ejhf.2911

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