CABG for Patients with Coronary Disease and Markedly Reduced Ejection Fraction?

In a randomized trial, coronary artery bypass grafting — compared with good medical therapy — did not lower mortality at 5 years.

Does coronary artery bypass grafting (CABG) lower medium-term mortality in patients with substantially reduced left ventricular ejection fraction (LVEF) and coronary artery disease suitable for CABG? To answer this question, researchers randomized 1200 patients with coronary disease and LVEF ≤35% either to optimal medical therapy alone or medical therapy plus CABG. Most patients had two- or three-vessel disease; patients with left main stenosis and severe angina were excluded. During the trial, 17% of medical-therapy patients crossed over to CABG.

After average follow-up of almost 5 years, all-cause mortality (the primary outcome) was similar in the CABG and medical therapy groups (36% and 41%; P=0.12). Early mortality was higher in the CABG…

Reviewing Author

Allan S. Brett, MD

Disclosures

Nothing to disclose

Allan S. Brett, MD

Disclosures

Nothing to disclose