Heart failure & cardiomyopathiesMeta-analysis
Coronary Revascularization for Heart Failure with Coronary Artery Disease: A Systematic Review and Meta-Analysis of Randomized Trials
- Systematic review and meta-analysis of randomised trials
- Randomized controlled trials (RCTs) were not blinded
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 participants · 5 RCTs
- Comparison
- Coronary revascularization vs medical therapy alone
- Outcome
- All-cause mortality
Pooled result
As reported in the abstract
Hazard ratio
0.88
95% CI 0.79–0.99
P = 0.0278
Coronary revascularization vs Medical therapy alone
HR 0.88 (95% CI 0.79–0.99); P = 0.0278
Further pooled results
| Outcome | HR (95% CI) | P value | |
|---|---|---|---|
| CV mortality | 0.80 (0.70–0.93) | P = 0.0024 | |
| HF hospitalization or all-cause mortality | 0.87 (0.74–1.01) | P = 0.0728 | |
| 0.512Hazard ratio (log scale) |
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
Summarised from the published abstract; every number is checked against it