In patients with coronary artery disease and heart failure, the addition of coronary-artery bypass grafting to medical therapy has no effect on the overall risk of death from any cause, but assessment of suitability for surgery may predict survival benefit in subgroups.

Commentary on: Velazquez EJ, Lee KL, Deja MA, et al. Coronary-artery bypass surgery in patients with left ventricular dysfunction. N Engl J Med 2011;364:1607–16.[OpenUrl][1][CrossRef][2][PubMed][3][Web of Science][4] More than 5.8 million Americans and 500 000 Canadians are currently living with heart failure (HF). The 5-year survival rate is a dismal 40–50%. Coronary artery disease (CAD) is the most common cause of HF, but the role of coronary artery bypass surgery (CABG) in HF has never been definitively established. The Surgical Treatment for Ischaemic HF trial aimed to determine whether CABG improves survival in patients with CAD and impaired left ventricular (LV) function (hypothesis 1). A total of 1212 adults with CAD amenable to CABG and left ventricular ejection fraction (LVEF) ≤35% were enrolled from 127 sites across 26 countries. The original intended enrolment of 2000 patients was revised due to slow enrolment rates, necessitating an increase in the duration of follow-up from … [1]: {openurl}?query=rft.jtitle%253DNew%2BEngland%2BJournal%2Bof%2BMedicine%26rft.stitle%253DNEJM%26rft.issn%253D0028-4793%26rft.aulast%253DVelazquez%26rft.auinit1%253DE.%2BJ.%26rft.volume%253D364%26rft.issue%253D17%26rft.spage%253D1607%26rft.epage%253D1616%26rft.atitle%253DCoronary-artery%2Bbypass%2Bsurgery%2Bin%2Bpatients%2Bwith%2Bleft%2Bventricular%2Bdysfunction.%26rft_id%253Dinfo%253Adoi%252F10.1056%252FNEJMoa1100356%26rft_id%253Dinfo%253Apmid%252F21463150%26rft.genre%253Darticle%26rft_val_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Ajournal%26ctx_ver%253DZ39.88-2004%26url_ver%253DZ39.88-2004%26url_ctx_fmt%253Dinfo%253Aofi%252Ffmt%253Akev%253Amtx%253Actx [2]: /lookup/external-ref?access_num=10.1056/NEJMoa1100356&link_type=DOI [3]: /lookup/external-ref?access_num=21463150&link_type=MED&atom=%2Febmed%2F17%2F6%2F178.atom [4]: /lookup/external-ref?access_num=000289940400007&link_type=ISI