Topic: Cardiovascular
Conditions
Interventions
1. Optimal medication plus angiography with, if appropriate, CABG
2. Optimal medication
Follow-up length: 60 months
Study entry: single randomisation o
Sponsors
Hull and East Yorkshire Hospitals NHS Trust (UK)
Eligibility
Sex/Gender
All
Inclusion criteria
Inclusion criteria: 1. Heart failure (in the investigators opinion) requiring chronic diuretic therapy 2. Coronary disease as the cause of heart failure as evidenced by a history of previous myocardial infarction, previous revascularisation or previous angiography 3. Left ventricular systolic dysfunction (ejection fraction less than 35%) 4. Stress-induced myocardial ischaemia or evidence of myocardial hibernation/stunning affecting five or more left ventricular segments in a 16-segment model 5. Male and female, lower age limit of 18 years
Exclusion criteria
Exclusion criteria: 1. Inability to give written informed consent. No age limits are stipulated but patients will have to be over 18 years to give consent and some patients may be considered too frail to survive surgery and would be excluded. 2. Patients who are not candidates for coronary artery bypass graft (CABG) surgery because of frailty or serious co-morbidity, e.g., severe lung disease, metastatic carcinoma. N.B. Some patients will be candidates for percutaneous transluminal coronary angioplasty (PTCA) but prior to randomisation (i.e. prior to doing an angiogram for study purposes) the investigator should be willing to send the patient to CABG surgery in case that is the preferred mode of revascularisation. 3. Unstable angina, myocardial infarction or stroke within the preceding 2 months 4. Patients being considered for revascularisation for the relief of chest pain (angina) or for valve surgery
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Survival | — |
Secondary
| Measure | Time frame |
|---|---|
| Determine whether coronary revascularisation reduces all-cause and cause-specific hospitalisation | — |
Countries
United Kingdom
Outcome results
None listed