What is the clinical evidence from this study?

Study design: Review. Population: Heart failure with coronary artery disease. Intervention: Myocardial revascularization (PCI or CABG) vs. Guideline-directed medical therapy.

What question did this study set out to answer?

This consensus statement examines the role of revascularization in patients with heart failure and coronary artery disease, emphasizing the need for tailored management strategies.

July 26, 2026European Journal of Heart FailureOpen Access

Revascularization of coronary artery disease in heart failure. A European Journal of Heart Failure Expert Consensus Statement

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Why the study?

Does myocardial revascularization (PCI or CABG) improve outcomes in heart failure patients with coronary artery disease compared to guideline-directed medical therapy?

Population

Heart failure patients with coronary artery disease (CAD), including HFrEF

Comparison

Myocardial revascularization by either… vs Guideline-directed medical therapy (GDMT)

Design

Guideline

Authors

BHBernhard HaringAlbert Einstein College of Medicine AIAntonio IaconelliUniversità Cattolica del Sacro Cuore DPDivaka PereraSt Thomas' Hospital

Discussion

Member takes

Implication

Requires heart team personalization of revascularization in HF-CAD; extends prior data by incorporating modern GDMT effects on outcomes.

Key Points

This consensus statement examines the role of revascularization in patients with heart failure and coronary artery disease, emphasizing the need for tailored management strategies.
Review of current literature on revascularization techniques, including PCI and CABG.
Assessment of the efficacy of modern pharmacological therapy in heart failure and coronary artery disease.
Discussion on patient selection criteria for revascularization procedures based on symptoms and ischemic burden.
CABG showed modest long-term benefits over guideline-recommended medical therapy in HFrEF prior to modern pharmacological advancements.
No significant benefit of revascularization reported in HFrEF patients under current medical therapies.
Revascularization options should be personalized and involve discussions within the heart team considering various patient-specific factors.

Structured PICO

Does myocardial revascularization (PCI or CABG) improve outcomes in heart failure patients with coronary artery disease compared to guideline-directed medical therapy?

Population

Heart failure patients with coronary artery disease (CAD), including HFrEF

Intervention

Myocardial revascularization by either percutaneous coronary intervention (PCI) or coronary artery bypass graft surgery (CABG)

Comparator

Guideline-directed medical therapy (GDMT)

This expert consensus statement recommends that revascularization in HF with CAD should be reserved for patients with persistent angina despite optimal GDMT, with decisions guided by a multidisciplinary heart team.

Limitations

Limited and conflicting evidence

Cite This Study

Haring et al. (2026) conducted a review in Heart failure with coronary artery disease. Myocardial revascularization (PCI or CABG) vs. Guideline-directed medical therapy was evaluated. Myocardial revascularization in heart failure with coronary artery disease lacks proven benefit over modern medical therapy unless angina persists, requiring individualized heart team discussion.

synapsesocial.com/papers/6a65a7b4d3aea3239cd7858f https://doi.org/10.1093/ejhf/xuag230

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Revascularization of coronary artery disease in heart failure. A European Journal of Heart Failure Expert Consensus Statement

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

Revascularization of coronary artery disease in heart failure. A European Journal of Heart Failure Expert Consensus Statement

Discussion

Member takes

Implication

Key Points

Structured PICO

Limitations

Cite This Study

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