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      A debate. Revascularización percutánea en miocardiopatía dilatada. A propósito del ensayo REVIVED BCIS2: visión del clínico Translated title: Debate. Percutaneous revascularization in dilated cardiomyopathy. Apropos of the REVIVED BCIS2 trial: the clinician's view

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      REC: Interventional Cardiology
      Sociedad Española de Cardiología

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          Coronary-Artery Bypass Surgery in Patients with Ischemic Cardiomyopathy.

          The survival benefit of a strategy of coronary-artery bypass grafting (CABG) added to guideline-directed medical therapy, as compared with medical therapy alone, in patients with coronary artery disease, heart failure, and severe left ventricular systolic dysfunction remains unclear.
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            Coronary-artery bypass surgery in patients with left ventricular dysfunction.

            The role of coronary-artery bypass grafting (CABG) in the treatment of patients with coronary artery disease and heart failure has not been clearly established. Between July 2002 and May 2007, a total of 1212 patients with an ejection fraction of 35% or less and coronary artery disease amenable to CABG were randomly assigned to medical therapy alone (602 patients) or medical therapy plus CABG (610 patients). The primary outcome was the rate of death from any cause. Major secondary outcomes included the rates of death from cardiovascular causes and of death from any cause or hospitalization for cardiovascular causes. The primary outcome occurred in 244 patients (41%) in the medical-therapy group and 218 (36%) in the CABG group (hazard ratio with CABG, 0.86; 95% confidence interval [CI], 0.72 to 1.04; P=0.12). A total of 201 patients (33%) in the medical-therapy group and 168 (28%) in the CABG group died from an adjudicated cardiovascular cause (hazard ratio with CABG, 0.81; 95% CI, 0.66 to 1.00; P=0.05). Death from any cause or hospitalization for cardiovascular causes occurred in 411 patients (68%) in the medical-therapy group and 351 (58%) in the CABG group (hazard ratio with CABG, 0.74; 95% CI, 0.64 to 0.85; P<0.001). By the end of the follow-up period (median, 56 months), 100 patients in the medical-therapy group (17%) underwent CABG, and 555 patients in the CABG group (91%) underwent CABG. In this randomized trial, there was no significant difference between medical therapy alone and medical therapy plus CABG with respect to the primary end point of death from any cause. Patients assigned to CABG, as compared with those assigned to medical therapy alone, had lower rates of death from cardiovascular causes and of death from any cause or hospitalization for cardiovascular causes. (Funded by the National Heart, Lung, and Blood Institute and Abbott Laboratories; STICH ClinicalTrials.gov number, NCT00023595.).
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              Percutaneous Revascularization for Ischemic Left Ventricular Dysfunction

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                Author and article information

                Journal
                recic
                REC: Interventional Cardiology
                REC Interv Cardiol ES
                Sociedad Española de Cardiología (Madrid, Madrid, Spain )
                2604-7306
                2604-7276
                December 2023
                : 5
                : 4
                : 299-301
                Affiliations
                [1] Madrid orgnameHospital Universitario La Paz orgdiv1Instituto de Investigación Sanitaria del Hospital Universitario La Paz (IdiPAZ) orgdiv2Servicio de Cardiología España
                Article
                S2604-73062023000400010 S2604-7306(23)00500400010
                10.24875/recic.m23000406
                78aed5f1-2f43-44ab-acce-dd1eb3de6da9

                This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.

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