{"doi":"10.1002/ejhf.2911","title":"Coronary Revascularization for Heart Failure with Coronary Artery Disease: A Systematic Review and Meta-Analysis of Randomized Trials","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:sec>\n                    <jats:title>Aims</jats:title>\n                    <jats:p>Coronary artery disease (CAD) is a common cause of heart failure (HF). Whether coronary revascularization improves outcomes in patients with HF receiving guideline-recommended pharmacological therapy (GRPT) remains uncertain; therefore, we conducted a systematic review and meta-analysis of relevant randomized controlled trials (RCTs).</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results</jats:title>\n                    <jats:p>We searched in public databases for RCTs published between 1 January 2001 and 22 November 2022, investigating the effects of coronary revascularization on morbidity and mortality in patients with chronic HF due to CAD. All-cause mortality was the primary outcome. We included five RCTs that enrolled, altogether, 2842 patients (most aged &amp;lt;65 years; 85% men; 67% with left ventricular ejection fraction ≤35%). Overall, compared to medical therapy alone, coronary revascularization was associated with a lower risk of all-cause mortality (hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.79–0.99; p = 0.0278) and cardiovascular mortality (HR 0.80, 95% CI 0.70–0.93; p = 0.0024) but not the composite of hospitalization for HF or all-cause mortality (HR 0.87, 95% CI 0.74–1.01; p = 0.0728). There were insufficient data to show whether the effects of coronary artery bypass graft surgery or percutaneous coronary intervention were similar or differed.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>For patients with chronic HF and CAD enrolled in RCTs, the effect of coronary revascularization on all-cause mortality was statistically significant but neither substantial (HR 0.88) nor robust (upper 95% CI close to 1.0). RCTs were not blinded, which may bias reporting of the cause-specific reasons for hospitalization and mortality. Further trials are required to determine which patients with HF and CAD obtain a substantial benefit from coronary revascularization by either coronary artery bypass graft surgery or percutaneous coronary intervention.</jats:p>\n                  </jats:sec>","journal":"European Journal of Heart Failure","year":2023,"id":637515,"datarank":0.47670807455219194,"base_score":3.1780538303479458,"endowment":3.1780538303479458,"self_citation_contribution":0.47670807455219194,"citation_network_contribution":0.0,"self_endowment_contribution":0.47670807455219194,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":23,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":null,"is_data_producer":false,"deposit_databanks":null,"is_oa":false,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":null,"fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":370039,"name":"Pierpaolo Pellicori","orcid":"0000-0001-7175-0464","position":1,"is_corresponding":false},{"id":1655392,"name":"Pasquale Dolce","orcid":null,"position":2,"is_corresponding":false},{"id":1655393,"name":"Matteo Busti","orcid":null,"position":3,"is_corresponding":false},{"id":1655394,"name":"Aureliano Ruggio","orcid":null,"position":4,"is_corresponding":false},{"id":1655395,"name":"Nadia Aspromonte","orcid":null,"position":5,"is_corresponding":false},{"id":1655396,"name":"Domenico D'Amario","orcid":null,"position":6,"is_corresponding":false},{"id":1655397,"name":"Mattia Galli","orcid":null,"position":7,"is_corresponding":false},{"id":1655398,"name":"Giuseppe Princi","orcid":null,"position":8,"is_corresponding":false},{"id":1371575,"name":"Elisabetta Caiazzo","orcid":"0000-0002-5667-5176","position":9,"is_corresponding":false},{"id":1655399,"name":"Asma O.M. Rezig","orcid":null,"position":10,"is_corresponding":false},{"id":651237,"name":"Pasquale Maffia","orcid":"0000-0003-3926-4225","position":11,"is_corresponding":false},{"id":1620803,"name":"Giovanni Pecorini","orcid":null,"position":12,"is_corresponding":false},{"id":84518,"name":"Filippo Crea","orcid":null,"position":13,"is_corresponding":false},{"id":49635,"name":"John G.F. Cleland","orcid":"0000-0002-1471-7016","position":14,"is_corresponding":false},{"id":1655391,"name":"Antonio Iaconelli","orcid":null,"position":0,"is_corresponding":false}],"reference_count":0,"raw_metadata":{"has_enrichment":true,"resolved":true,"title":"Coronary Revascularization for Heart Failure with Coronary Artery Disease: A Systematic Review and Meta-Analysis of Randomized Trials","abstract":"<jats:title>Abstract</jats:title>\n                  <jats:sec>\n                    <jats:title>Aims</jats:title>\n                    <jats:p>Coronary artery disease (CAD) is a common cause of heart failure (HF). Whether coronary revascularization improves outcomes in patients with HF receiving guideline-recommended pharmacological therapy (GRPT) remains uncertain; therefore, we conducted a systematic review and meta-analysis of relevant randomized controlled trials (RCTs).</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods and results</jats:title>\n                    <jats:p>We searched in public databases for RCTs published between 1 January 2001 and 22 November 2022, investigating the effects of coronary revascularization on morbidity and mortality in patients with chronic HF due to CAD. All-cause mortality was the primary outcome. We included five RCTs that enrolled, altogether, 2842 patients (most aged &amp;lt;65 years; 85% men; 67% with left ventricular ejection fraction ≤35%). Overall, compared to medical therapy alone, coronary revascularization was associated with a lower risk of all-cause mortality (hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.79–0.99; p = 0.0278) and cardiovascular mortality (HR 0.80, 95% CI 0.70–0.93; p = 0.0024) but not the composite of hospitalization for HF or all-cause mortality (HR 0.87, 95% CI 0.74–1.01; p = 0.0728). There were insufficient data to show whether the effects of coronary artery bypass graft surgery or percutaneous coronary intervention were similar or differed.</jats:p>\n                  </jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions</jats:title>\n                    <jats:p>For patients with chronic HF and CAD enrolled in RCTs, the effect of coronary revascularization on all-cause mortality was statistically significant but neither substantial (HR 0.88) nor robust (upper 95% CI close to 1.0). RCTs were not blinded, which may bias reporting of the cause-specific reasons for hospitalization and mortality. Further trials are required to determine which patients with HF and CAD obtain a substantial benefit from coronary revascularization by either coronary artery bypass graft surgery or percutaneous coronary intervention.</jats:p>\n                  </jats:sec>","is_dataset_classified":null,"base_score":3.1780538303479458,"endowment":3.1780538303479458,"datacite_reuse_total":0,"file_count":0,"downloads":0,"views":0,"has_version_chain":false,"is_dataset":false,"is_oa":false,"pmid":"37211964","pmcid":null,"openalex_id":"https://openalex.org/W4377219971","authors":[],"funders":[],"total_grants":0,"fwci":1.913,"citation_percentile":0.85547786,"influential_citations":0,"citation_trend":[{"year":2023,"count":4},{"year":2024,"count":3},{"year":2025,"count":12},{"year":2026,"count":4}],"oa_status":"bronze","license":"cc-by-nc","oa_locations":[{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ejhf.2911","host_type":"journal"},{"url":"https://onlinelibrary.wiley.com/doi/pdfdirect/10.1002/ejhf.2911","host_type":"publisher"},{"url":"https://academic.oup.com/eurjhf/article-pdf/25/7/1094/65494400/eurjhf_25_7_1094.pdf","host_type":"publisher"},{"url":"https://doi.org/10.1002/ejhf.2911","host_type":"journal"},{"url":"https://pubmed.ncbi.nlm.nih.gov/37211964","host_type":"repository"},{"url":"https://eprints.gla.ac.uk/view/journal_volume/European_Journal_of_Heart_Failure.html>,","host_type":"journal"},{"url":"https://hdl.handle.net/10807/303693","host_type":"repository"},{"url":"https://eprints.gla.ac.uk/298810/2/298810.pdf","host_type":"repository"},{"url":"https://publicatt.unicatt.it/bitstream/10807/303693/1/European%20J%20of%20Heart%20Fail%20-%202023%20-%20Iaconelli%20-%20Coronary%20revascularization%20for%20heart%20failure%20with%20coronary%20artery%20disease%20A.pdf","host_type":"repository"}],"fields_of_study":["Cardiac Imaging and Diagnostics","Coronary Interventions and Diagnostics","Cardiac, Anesthesia and Surgical Outcomes","Male","Humans","Female","Coronary Artery Disease","Heart Failure","Randomized Controlled Trials as Topic","Coronary Artery Bypass","Stroke Volume","Percutaneous Coronary Intervention","Treatment Outcome"],"mesh_terms":["Coronary Artery Bypass","Coronary Artery Disease","Female","Heart Failure","Humans","Male","Stroke Volume","Randomized Controlled Trials as Topic","Treatment Outcome","Percutaneous Coronary Intervention"],"keywords":["Medicine","Internal medicine","Coronary artery disease","Cardiology","Revascularization","Hazard ratio","Percutaneous coronary intervention","Randomized controlled trial","Heart failure","Ejection fraction","Confidence interval","Meta-analysis","Myocardial infarction"],"sdg_mappings":[{"sdg_number":0,"sdg_label":"Good health and well-being"}],"linked_datasets":[],"clinical_trials":[],"software_tools":[],"database_accessions":[],"source":"live","citation_network_status":"fetched"},"created_at":"2026-08-06T19:05:12.568083Z","pmid":null,"pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}