CABG vs. Medical Therapy in Patients with Ischemic Left Ventricular Systolic Dysfunction

Coronary artery bypass grafting might reduce the risk for some negative outcomes in patients with ischemic LVSD, but it does not appear to prolong life.

Decisions surrounding the use of bypass surgery in patients with ischemic left ventricular systolic dysfunction (LVSD) are challenging. First, although some consider it an article of faith that bypass for multivessel coronary disease provides the greatest benefit for patients with LVSD, the clinical trials that underlie this belief almost entirely excluded patients with severe LVSD. Furthermore, medical therapy has evolved considerably since publication of the seminal coronary artery bypass grafting (CABG) trials. Second, although some evidence supports an association between myocardial viability and recovery of LV function after revascularization, whether CABG improves more-meaningful outcomes in patients with myocardial viability is not e…

Reviewing Author

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)

Frederick A. Masoudi, MD, MSPH, FACC, FAHA

Disclosures

Consultant/Advisory BoardBristol Myers Squibb; CPC Clinical Research

Grant/Research SupportNational Heart, Lung, and Blood Institute

Editorial BoardsUpToDate; American College of Cardiology Self-Assessment Program (SAP)

Leadership Positions in Professional SocietiesAmerican College of Cardiology (Chair, Innovations Committee)