The prevalence of heart failure is increasing in Western society and represents an important public health problem. Deciding whether surgical (revascularization) or nonsurgical treatment of heart failure would be better, in terms of risks versus benefits, is difficult. Using data from the Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH), Tsuyuki and associates compare survival outcomes among patients with heart failure treated medically and those who underwent coronary revascularization. In a related commentary, Senior notes the limitations of retrospective, observational studies and the ongoing uncertainty about the safety and benefits of revascularization in patients with heart failure and coronary artery disease.
Revascularization in patients with heart failure
Ross T. Tsuyuki, Fiona M. Shrive, P. Diane Galbraith, Merril L. Knudtson, Michelle M. Graham for the APPROACH Investigators
http://www.cmaj.ca/pressrelease/pg361.pdf
To revascularize or not to revascularize: a dilemma in heart failure
Roxy Senior
http://www.cmaj.ca/pressrelease/pg372.pdf
Canadian Medical Association Journal