Role of Coronary Revascularization in Patients with Ischemic Heart Disease and Heart Failure with Reduced Ejection Fraction

Heart failure with reduced ejection fraction (HFrEF) is a major contributor to cardiovas-cular morbidity and mortality, with ischemic heart disease as the leading etiology. Despite advances in optimal medical treatment (OMT), the additional benefit of coronary revascularization in this population remains uncertain. While some studies describe a potential benefit in revascularization - particularly with coronary artery bypass grafting (CABG)- this benefit has not been consistently observed with percutaneous coronary intervention (PCI). Moreover, in this context, the role of myocardial hibernation has been called into question. Additionally, recent advances in the medical management of heart failure complicate the current interpretation of previous studies and underscores the need for new clinical trials