PCI adds ‘no mortality benefit’ in treating severe ischaemic LV dysfunction

A trial shows similar event rates for patients undergoing revascularisation as those receiving optimal medical therapy alone

UK doctors have questioned the value of percutaneous revascularisation in severe ischaemic left ventricular dysfunction after a study showing no clinical benefit versus standard care.

Analysis of data from 700 patients suggests that adding percutaneous coronary intervention (PCI) to optimal medical therapy does not lower the risk of all-cause mortality or hospitalisation for heart failure (HF).

The REVIVED (Revascularisation for Ischaemic Ventricular Dysfunction) trial investigators say their findings “challenge the paradigm of myocardial hibernation”.

In their randomised trial, the researchers assigned older adults with a left ventricular ejection fraction (LVEF) of 35% of less, extensive coronary artery disease and demonstrable myocardial viability to either PCI plus standard care or standard care alone.