Heart failure with left ventricular systolic dysfunction Circulatory System Heart failure with left ventricular systolic dysfunction
Conditions
Interventions
Best medical therapy versus best medical therapy and revascularisation
Sponsors
Medical Research Council (MRC) (UK)
Eligibility
Inclusion criteria
Inclusion criteria: 1. Heart failure (in the investigators' opinion) with left ventricular systolic dysfunction (ejection fraction less than 35%) 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. Stress-induced myocardial ischaemia or evidence of myocardial hibernation/stunning affecting five or more left ventricular segments in a 16-segment model. The core laboratories will make the decision about whether the test identifies a sufficient volume of affected myocardium
Exclusion criteria
Exclusion criteria: 1. Patients who are not candidates for Coronary Artery Bypass Graft (CABG) because of frailty or serious co-morbidity (eg:- severe lung disease, metastatic carcinoma) 2. Unstable angina, myocardial infarction or stroke within the preceding two months 3. Inability to give written informed consent 4. Unwilling to consent to being contacted directly by staff at the data centre or unwilling to allow their hospital notes to be copied and sent to the data centre 5. Patients being considered for revascularisation for the relief of chest pain (angina) or valve surgery 6. Patients involved in another randomised controlled trial
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| All-cause mortality | — |
Secondary
| Measure | Time frame |
|---|---|
| 1. All-cause mortality or myocardial infarction more than 72 hours from coronary revascularisation 2. All-cause mortality and all-cause hospitalisation 3. All-cause mortality and unplanned cardiovascular hospitalisation 4. Days alive and out of hospital 5. Death, non-fatal myocardial infarction or non-fatal stroke 6. Symptom scores for angina and heart failure 7. Quality of life (using EuroHeart Failure, EQ-5D and Minnesota Living with Heart Failure Questionnaires) 8. Mean cost of Therapy (a health economic outcome) | — |
Countries
United Kingdom
Outcome results
None listed