Interventions Beat Optimal Medical Care in Heart Failure Patients with Reduced Ejection Fraction

Medical treatment is not as good as revascularization when it comes to survival in patients who have heart failure characterized by reduced ejection fraction, a multi-national study has found.

In a meta analysis of available studies comparing percutaneous and surgical coronary revascularization to optimal medical care, Dimitrios Dimitroulis of University Hospital Dusseldorf, Dusseldorf, Germany and colleagues there and in Poland and Cincinnati, OH, found significant improved survival with coronary artery bypass grafting (CABG) or percutaneous coronary intervention (PCI).

The study was reported at the European Society of Cardiology's ESC Congress 2016 in Rome, Italy.

Reduced ejection fraction was defined for study purposes as less than 40%.

The team analyzed 20 studies with a total 13,286 patients. They found that compared to medical treatment there was a significant reduction in mortality with CABG (odds ratio 0.53) and PCI (Odds ratio 0.5).

They also looked at how PCI stacked up agains CABG.

"CABG showed superior efficacy in reducing mortality," they found, at least for this group of patients with reduced pumping capacity.

"These findings if confirmed in a large randomized controlled trial might have a profound impact on public health," they researchers concluded.