Can revascularization improve outcomes for patients with severe heart dysfunction? This review examines the effectiveness of percutaneous coronary intervention (PCI) compared to optimal medical therapy (OMT) in individuals with severe ischemic left ventricular dysfunction. Recent findings from the REVIVED-BCIS2 trial showed no significant difference in all-cause mortality, heart failure hospitalization, or LVEF improvement between PCI plus OMT and OMT alone. Furthermore, the analysis incorporates results from the STICH randomized trial, indicating that CABG (Coronary Artery Bypass Grafting) plus medical therapy reduced cardiovascular disease-related deaths and hospitalizations after 5 years, with a significant decrease in all-cause mortality observed at the 10-year follow-up. In conclusion, currently available evidence suggests that PCI does not offer apparent benefits compared to OMT in patients with severe ischemic cardiomyopathy, while CABG improves outcomes in this patient population. The review underscores the necessity for optimization of medical therapy until more evidence supports the advantages of PCI.
As a publication dedicated to cardiology, Current Cardiology Reports offers an appropriate platform for this review. The article addresses a critical question in the management of ischemic left ventricular dysfunction, providing a concise summary of current evidence and highlighting the need for further research in percutaneous coronary intervention (PCI), thus emphasizing its significance within the scope of the journal.