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Coronary revascularization in heart failure 

Coronary revascularization in heart failure
Chapter:
Coronary revascularization in heart failure
Author(s):

Roy S. Gardner

, Theresa A. McDonagh

, and Niki L. Walker

DOI:
10.1093/med/9780199674152.003.0007
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date: 22 February 2020

Ischaemic heart disease (IHD) is the most common cause of heart failure in westernized countries, and the survival of patients with ischaemic cardiomyopathy is poorer than those with non-ischaemic aetiology. Ischaemic cardiomyopathy involves two distinct pathological processes; myocardial infarction with irreversible damage, and myocardial ischaemia. The rigour with which the diagnosis of IHD is sought varies from centre to centre, with some still performing diagnostic coronary angiography in all HF subjects. However, in light of the STICH (Surgical Treatment for Ischemic Heart Failure) data which did not support the practice of revascularisation in patients with heart failure and asymptomatic coronary artery disease, most cardiologists now restrict coronary angiography to those with chest pain or evidence of ischaemia on non-invasive testing. This chapter summarizes the data available on coronary revascularization.

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