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Open Access 26-07-2023 | CABG

Understanding the role of coronary artery revascularization in patients with left ventricular dysfunction and multivessel disease

Authors: Vincenzo Acerbo, Arturo Cesaro, Gianmaria Scherillo, Giovanni Signore, Francesco Paolo Rotolo, Gianantonio De Michele, Francesco Scialla, Giuseppe Raucci, Domenico Panico, Fabio Fimiani, Elisabetta Moscarella, Felice Gragnano, Paolo Calabrò

Published in: Heart Failure Reviews | Issue 6/2023

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Coronary artery disease (CAD) is the most common cause of heart failure with reduced ejection fraction (HFrEF). Advances and innovations in medical therapy have been shown to play a crucial role in improving the prognosis of patients with CAD and HFrEF; however, mortality rate in these patients remains high, and the role of surgical and/or percutaneous revascularization strategy is still debated. The Surgical Treatment for Ischemic Heart Failure (STICH) trial and the Revascularization for Ischemic Ventricular Dysfunction (REVIVED) trial have attempted to provide an answer to this issue. Nevertheless, the results of these two trials have generated further uncertainties. Their findings do not provide a definitive answer about the ideal clinical phenotype for surgical or percutaneous coronary revascularization and dispute the historical dogma on myocardial viability and the theory of myocardial hibernation, raising new questions about the proper selection of patients who are candidates for coronary revascularization. The aim of this review is to provide an overview on the actual available evidence of coronary artery revascularization in patients with CAD and left ventricular dysfunction and to suggest new insights on the proper selection and management strategies in this high-risk clinical setting.
Understanding the role of coronary artery revascularization in patients with left ventricular dysfunction and multivessel disease
Vincenzo Acerbo
Arturo Cesaro
Gianmaria Scherillo
Giovanni Signore
Francesco Paolo Rotolo
Gianantonio De Michele
Francesco Scialla
Giuseppe Raucci
Domenico Panico
Fabio Fimiani
Elisabetta Moscarella
Felice Gragnano
Paolo Calabrò
Publication date
Springer US
Published in
Heart Failure Reviews / Issue 6/2023
Print ISSN: 1382-4147
Electronic ISSN: 1573-7322

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