Why is this study important?
- Patients with reduced left ventricular ejection fraction and coronary artery disease suffer from high rates of morbidity and mortality despite medical therapy.
- PCI for the treatment of such patients is frequently performed, with the hopes of improving prognosis.
- REVIVED-BCIS2 is the first large randomized controlled trial to study the effects of PCI in such patients.
What question was this study supposed to answer?
- CABG has been shown to reduce 10-year (but not 5-year) mortality in patients with ischemic cardiomyopathy. However, CABG has a substantial early mortality risk, and this fact combined with its morbidity, makes CABG an unacceptable option in many patients.
- Whether PCI, which has less procedural morbidity and mortality than CABG, has a benefit in these patients is an unanswered question.
What did the study show?
- 700 patients with chronic coronary disease and severely reduced LV function, but mild or no symptoms were randomized to optimal medical therapy with and without PCI.
- At a median follow-up of 41 months, there was no difference in death or heart failure hospitalization (the primary endpoint) or the 12-month LV function in patients treated with or without PCI.
- PCI did reduce spontaneous myocardial infarctions, and improved symptoms during the 12 months of follow-up, although this difference diminished by 24 months.
- The benefits of PCI in the long term, and in patients with ischemic cardiomyopathy with more than mild symptoms, have yet to be rigorously studied.
Other Specialist Resources for Coronary Heart Disease
Including recently published studies, coverage of late-breaking science, updates from clinical trials and registries, and complex case presentations.
Clinical Interest Article
OCT vs. Angiography for Guidance of Calcified Lesions PCI: The CALIPSO Trial —Coverage of EuroPCR 2024
Integrated Search Topics