Heart failure & cardiomyopathiesSecondary analysis

Impact of Anatomical and Viability-Guided Completeness of Revascularization on Clinical Outcomes in Ischemic Cardiomyopathy

J Am Coll CardiolPublished

  • Secondary analysis of the REVIVED-BCIS2 randomised trial
  • independent core laboratories

Authors' conclusion

In patients with severe LV dysfunction, neither complete anatomical nor viability-guided revascularization was associated with improved event-free survival compared with incomplete revascularization or treatment with medical therapy alone.

Study context

Population
Patients with severe left ventricular (LV) dysfunction (ischemic cardiomyopathy) in REVIVED-BCIS2 with angiograms and viability studies availableof 700 randomized
Participants
670 patients
Comparison
Complete anatomical or viability-guided revascularization (percutaneous coronary intervention (PCI)) vs optimal medical therapy alone
Primary endpoint
Death or hospitalization for HF

Primary result

As reported in the abstract

Each group vs optimal medical therapy aloneHazard ratio (95% CI)
Complete anatomical revascularization
0.90(0.62–1.32)
Complete viability-guided revascularization
0.95(0.66–1.35)

Further findings

Median completeness of revascularization (PCI)

Median RIcoro
67%
Median RImyo
85%

Sensitivity analysis by residual SYNTAX score

No association with outcome

Original publication

Impact of Anatomical and Viability-Guided Completeness of Revascularization on Clinical Outcomes in Ischemic Cardiomyopathy. J Am Coll Cardiol. Published 15 May 2024. doi:10.1016/j.jacc.2024.04.043

Summarised from the published abstract; every number is checked against it