2023
Current Landscape and Future Directions of Coronary Revascularization in Ischemic Systolic Heart Failure: A Review
Chuy K, Velazquez E, Lansky A, Jamil Y, Ahmad Y. Current Landscape and Future Directions of Coronary Revascularization in Ischemic Systolic Heart Failure: A Review. Journal Of The Society For Cardiovascular Angiography & Interventions 2023, 2: 101197. PMID: 39131064, PMCID: PMC11307589, DOI: 10.1016/j.jscai.2023.101197.Peer-Reviewed Original ResearchIschemic systolic heart failureSystolic heart failurePercutaneous coronary interventionHeart failureMedical therapyCoronary revascularizationBenefits of PCITrials of PCILeft ventricular systolic dysfunctionPrevalence of HFBenefit of CABGContemporary medical therapyIschemic ventricular dysfunctionCoronary artery bypassVentricular systolic dysfunctionCoronary artery diseaseIschemic heart diseaseAcute cardiac careComparative clinical effectivenessUnmet clinical needRecent revascularizationArtery bypassSystolic dysfunctionVentricular dysfunctionCoronary intervention
2022
Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial
Ghazi L, O'Connor K, Yamamoto Y, Fuery M, Sen S, Samsky M, Riello R, Huang J, Olufade T, McDermott J, Inzucchi S, Velazquez E, Wilson F, Desai N, Ahmad T. Pragmatic trial of messaging to providers about treatment of acute heart failure: The PROMPT-AHF trial. American Heart Journal 2022, 257: 111-119. PMID: 36493842, DOI: 10.1016/j.ahj.2022.12.002.Peer-Reviewed Original ResearchConceptsGuideline-directed medical therapyAcute heart failureHeart failurePragmatic trialElectronic health recordsSubstantial health care costsBest practice advisoryReduced ejection fractionUsual care armHealth recordsTime of dischargeEvidence-based careHealth care costsClinical decision support systemAHF patientsCare armEligible patientsHF hospitalizationInpatient initiationCardiovascular deathMedication classesEjection fractionMedical therapyPrimary outcomePractice advisoryPCI in Patients With Heart Failure: Current Evidence, Impact of Complete Revascularization, and Contemporary Techniques to Improve Outcomes
Ahmad Y, Petrie M, Jolicoeur E, Madhavan M, Velazquez E, Moses J, Lansky A, Stone G. PCI in Patients With Heart Failure: Current Evidence, Impact of Complete Revascularization, and Contemporary Techniques to Improve Outcomes. Journal Of The Society For Cardiovascular Angiography & Interventions 2022, 1: 100020. PMID: 39132568, PMCID: PMC11307477, DOI: 10.1016/j.jscai.2022.100020.Peer-Reviewed Original ResearchPercutaneous coronary interventionLeft ventricular systolic dysfunctionCoronary artery diseaseHeart failureComplete revascularizationMedical therapyClinical outcomesClinical trialsCoronary artery bypassVentricular systolic dysfunctionClinical trial evidenceHigh operative riskHigh-risk patientsMajor cardiac surgeryExtent of revascularizationMinority of patientsFuture clinical trialsArtery bypassCause mortalityPeriprocedural complicationsSystolic dysfunctionCoronary interventionOperative riskArtery diseaseCardiac surgery
2021
Optimal medical therapy with or without surgical revascularization and long-term outcomes in ischemic cardiomyopathy
Farsky PS, White J, Al-Khalidi HR, Sueta CA, Rouleau J, Panza J, Velazquez E, O'Connor C, Investigators W, Dabrowski R, Djokovic L, Drazner M, Haddad H, Ali I, Keltai M, Naik A, Sopko G, Golba K, Andersson B, Carson P, Kukulski T. Optimal medical therapy with or without surgical revascularization and long-term outcomes in ischemic cardiomyopathy. Journal Of Thoracic And Cardiovascular Surgery 2021, 164: 1890-1899.e4. PMID: 33610365, PMCID: PMC8260609, DOI: 10.1016/j.jtcvs.2020.12.094.Peer-Reviewed Original ResearchConceptsOptimal medical therapyCoronary artery bypassMedical therapyArtery bypassIschemic cardiomyopathyCause mortalityIschemic Heart Failure (STICH) trialVentricular ejection fraction 35Improved long-term survivalEjection fraction 35Angiotensin receptor blockersHeart Failure TrialLower cardiovascular mortalityMultivariable Cox modelOutcomes of patientsVentricular ejection fractionCoronary artery diseaseLong-term outcomesLong-term survivalSurgical revascularizationReceptor blockersCardiovascular mortalityAntiplatelet drugsArtery diseaseEjection fraction
2019
Percutaneous coronary intervention outcomes in patients with stable coronary disease and left ventricular systolic dysfunction
DeVore AD, Yow E, Krucoff MW, Sherwood MW, Shaw LK, Chiswell K, O'Connor CM, Ohman EM, Velazquez EJ. Percutaneous coronary intervention outcomes in patients with stable coronary disease and left ventricular systolic dysfunction. ESC Heart Failure 2019, 6: 1233-1242. PMID: 31560171, PMCID: PMC6989282, DOI: 10.1002/ehf2.12510.Peer-Reviewed Original ResearchConceptsStable coronary artery diseasePercutaneous coronary interventionCoronary artery diseaseVentricular systolic dysfunctionSevere left ventricular systolic dysfunctionLeft ventricular systolic dysfunctionSystolic dysfunctionMedical therapyCardiovascular hospitalizationAddition of PCICanadian Cardiovascular Society class IIIImpact of PCIPercutaneous coronary intervention outcomesDuke University Medical CenterComposite of mortalityPropensity-matched cohortStable coronary diseaseAcute coronary syndromeHigh-risk patientsLong-term mortalityVentricular ejection fractionCox proportional hazardsUniversity Medical CenterCause mortalityCoronary syndromeMyocardial Viability and Long-Term Outcomes in Ischemic Cardiomyopathy
Panza JA, Ellis AM, Al-Khalidi HR, Holly TA, Berman DS, Oh JK, Pohost GM, Sopko G, Chrzanowski L, Mark DB, Kukulski T, Favaloro LE, Maurer G, Farsky PS, Tan RS, Asch FM, Velazquez EJ, Rouleau JL, Lee KL, Bonow RO. Myocardial Viability and Long-Term Outcomes in Ischemic Cardiomyopathy. New England Journal Of Medicine 2019, 381: 739-748. PMID: 31433921, PMCID: PMC6814246, DOI: 10.1056/nejmoa1807365.Peer-Reviewed Original ResearchMeSH KeywordsAgedCoronary Artery BypassEchocardiography, StressFemaleFollow-Up StudiesHeartHumansIncidenceKaplan-Meier EstimateMaleMiddle AgedMyocardial IschemiaProportional Hazards ModelsProspective StudiesStroke VolumeTomography, Emission-Computed, Single-PhotonTreatment OutcomeVentricular Function, LeftConceptsLeft ventricular ejection fractionVentricular ejection fractionMedical therapyEjection fractionMyocardial viabilityIschemic cardiomyopathyLeft ventricular systolic functionGoals of revascularizationCoronary artery bypassPrimary end pointVentricular systolic functionCoronary artery diseaseLeft ventricular functionLong-term outcomesLong-term survivalSurgical revascularizationDobutamine echocardiographyMedian durationSystolic functionArtery diseaseVentricular functionViable myocardiumLong-term benefitsLower incidenceCABGPCI and CABG for Treating Stable Coronary Artery Disease JACC Review Topic of the Week
Doenst T, Haverich A, Serruys P, Bonow RO, Kappetein P, Falk V, Velazquez E, Diegeler A, Sigusch H. PCI and CABG for Treating Stable Coronary Artery Disease JACC Review Topic of the Week. Journal Of The American College Of Cardiology 2019, 73: 964-976. PMID: 30819365, DOI: 10.1016/j.jacc.2018.11.053.Peer-Reviewed Original ResearchConceptsPercutaneous coronary interventionMyocardial infarctionStable coronary artery diseaseMajority of infarctsCoronary artery bypassCoronary artery diseaseFlow-limiting lesionsNew infarctsArtery bypassCoronary interventionInfarct reductionArtery diseaseMedical therapyRevascularization proceduresVessel occlusionCABGSurvival effectReview TopicTreatment effectsInfarctionInfarctsIschemia detectionRevascularizationStenosisBypassBurden of medical co‐morbidities and benefit from surgical revascularization in patients with ischaemic cardiomyopathy
Ambrosy AP, Stevens SR, Al‐Khalidi H, Rouleau JL, Bouabdallaoui N, Carson PE, Adlbrecht C, Cleland JGF, Dabrowski R, Golba KS, Pina IL, Sueta CA, Roy A, Sopko G, Bonow RO, Velazquez EJ, Investigators O. Burden of medical co‐morbidities and benefit from surgical revascularization in patients with ischaemic cardiomyopathy. European Journal Of Heart Failure 2019, 21: 373-381. PMID: 30698316, PMCID: PMC6818499, DOI: 10.1002/ejhf.1404.Peer-Reviewed Original ResearchConceptsCharlson co-morbidity indexCCI scoreSurgical revascularizationEjection fractionMedical therapySTICH trialHeart failureIschemic cardiomyopathyKansas City Cardiomyopathy QuestionnaireCo-morbidity indexCoronary artery bypassCo-morbid conditionsHealth-related qualityCoronary artery diseaseRisk of deathProportional hazards modelYears of ageTreatment effectsGreater functional limitationsArtery bypassCause mortalityIschemic etiologyArtery diseaseWalk testBaseline confounders
2018
A meta‐analysis of MitraClip combined with medical therapy vs. medical therapy alone for treatment of mitral regurgitation in heart failure patients
Giannini C, D'ascenzo F, Fiorelli F, Spontoni P, Swaans MJ, Velazquez EJ, Armeni P, Adamo M, De Carlo M, Petronio AS. A meta‐analysis of MitraClip combined with medical therapy vs. medical therapy alone for treatment of mitral regurgitation in heart failure patients. ESC Heart Failure 2018, 5: 1150-1158. PMID: 30191666, PMCID: PMC6300824, DOI: 10.1002/ehf2.12339.Peer-Reviewed Original ResearchConceptsFunctional mitral regurgitationMedical therapyMitral regurgitationSurvival benefitConservative treatmentPercutaneous mitral valve repairEffect of MitraClipRobust survival benefitSignificant survival benefitCardiac resynchronization therapyEligible observational studiesHeart failure patientsVentricular ejection fractionMitral valve repairPatient-level analysisComprehensive literature searchStudy-level analysisConservative therapyIschemic etiologyPrimary endpointFailure patientsMultivariate adjustmentEjection fractionResynchronization therapySurvival outcomesSix-minute walk distance after coronary artery bypass grafting compared with medical therapy in ischaemic cardiomyopathy
Stewart RAH, Szalewska D, Stebbins A, Al-Khalidi HR, Cleland JGH, Rynkiewicz A, Drazner MH, White HD, Mark DB, Roy A, Kosevic D, Rajda M, Jasinski M, Leng CY, Tungsubutra W, Desvigne-Nickens P, Velazquez EJ, Petrie MC. Six-minute walk distance after coronary artery bypass grafting compared with medical therapy in ischaemic cardiomyopathy. Open Heart 2018, 5: e000752. PMID: 29531766, PMCID: PMC5845417, DOI: 10.1136/openhrt-2017-000752.Peer-Reviewed Original ResearchCoronary artery bypass surgeryIschemic left ventricular dysfunctionLeft ventricular dysfunctionWalk distanceVentricular dysfunctionMedical therapyMED groupFunctional capacityNew York Heart Association classSix-minute walk distanceMin walk distanceCoronary artery bypassArtery bypass surgeryVentricular ejection fractionCoronary artery diseaseArtery bypassBypass surgeryArtery diseaseAssociation classEjection fractionIschemic cardiomyopathySurgical treatmentTreatment allocationDisease trialsPatients
2016
Ten-Year Outcomes After Coronary Artery Bypass Grafting According to Age in Patients With Heart Failure and Left Ventricular Systolic Dysfunction
Petrie MC, Jhund PS, She L, Adlbrecht C, Doenst T, Panza JA, Hill JA, Lee KL, Rouleau JL, Prior DL, Ali IS, Maddury J, Golba KS, White HD, Carson P, Chrzanowski L, Romanov A, Miller AB, Velazquez EJ. Ten-Year Outcomes After Coronary Artery Bypass Grafting According to Age in Patients With Heart Failure and Left Ventricular Systolic Dysfunction. Circulation 2016, 134: 1314-1324. PMID: 27573034, PMCID: PMC5089908, DOI: 10.1161/circulationaha.116.024800.Peer-Reviewed Original ResearchConceptsCoronary artery bypassCause mortalityMedical therapyCardiovascular mortalityYounger patientsEjection fractionHeart failureCABG groupArtery bypassOlder patientsCardiovascular hospitalizationBenefit of CABGEfficacy of CABGCardiopulmonary bypass timeReduced ejection fractionVentricular systolic dysfunctionBaseline ejection fractionCoronary artery diseaseEffect of CABGTen-year outcomesConsistent beneficial effectsMore comorbiditiesSTICH trialBypass timeCardiovascular deathCoronary-Artery Bypass Surgery in Patients with Ischemic Cardiomyopathy
Velazquez EJ, Lee KL, Jones RH, Al-Khalidi HR, Hill JA, Panza JA, Michler RE, Bonow RO, Doenst T, Petrie MC, Oh JK, She L, Moore VL, Desvigne-Nickens P, Sopko G, Rouleau JL. Coronary-Artery Bypass Surgery in Patients with Ischemic Cardiomyopathy. New England Journal Of Medicine 2016, 374: 1511-1520. PMID: 27040723, PMCID: PMC4938005, DOI: 10.1056/nejmoa1602001.Peer-Reviewed Original ResearchConceptsMedical therapy groupCardiovascular causesCoronary artery diseaseMedical therapyCABG groupArtery diseaseIschemic cardiomyopathySevere left ventricular systolic dysfunctionGuideline-directed medical therapyLeft ventricular systolic dysfunctionMajor secondary outcomesCoronary artery bypassPrimary outcome eventVentricular systolic dysfunctionArtery bypass surgeryCohort of patientsRate of deathSystolic dysfunctionBypass surgeryMedian durationSecondary outcomesSurvival benefitEjection fractionHeart failurePrimary outcomeAortic valve surgery and survival in patients with moderate or severe aortic stenosis and left ventricular dysfunction
Samad Z, Vora AN, Dunning A, Schulte PJ, Shaw LK, Al-Enezi F, Ersboll M, McGarrah RW, Vavalle JP, Shah SH, Kisslo J, Glower D, Harrison JK, Velazquez EJ. Aortic valve surgery and survival in patients with moderate or severe aortic stenosis and left ventricular dysfunction. European Heart Journal 2016, 37: 2276-2286. PMID: 26787441, PMCID: PMC5841220, DOI: 10.1093/eurheartj/ehv701.Peer-Reviewed Original ResearchConceptsAortic valve surgerySevere aortic stenosisModerate aortic stenosisAortic stenosisValve surgeryMean gradientMultivariable Cox modelVentricular systolic dysfunctionCoronary artery bypassHigh-risk cohortCurrent practice patternsArtery bypassCause mortalityEchocardiographic databaseSystolic dysfunctionVentricular dysfunctionMultivariable adjustmentTranscatheter approachMedical therapyPractice patternsBetter survivalCABGCox modelPatientsLower mortality
2015
Importance of Angina in Patients With Coronary Disease, Heart Failure, and Left Ventricular Systolic Dysfunction Insights From STICH
Jolicœur EM, Dunning A, Castelvecchio S, Dabrowski R, Waclawiw MA, Petrie MC, Stewart R, Jhund PS, Desvigne-Nickens P, Panza JA, Bonow RO, Sun B, San TR, Al-Khalidi HR, Rouleau JL, Velazquez EJ, Cleland JGF. Importance of Angina in Patients With Coronary Disease, Heart Failure, and Left Ventricular Systolic Dysfunction Insights From STICH. Journal Of The American College Of Cardiology 2015, 66: 2092-2100. PMID: 26541919, PMCID: PMC4655599, DOI: 10.1016/j.jacc.2015.08.882.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseLV systolic dysfunctionGreater survival benefitMedical therapySystolic dysfunctionCause mortalitySurvival benefitWorse prognosisCoronary artery bypass graft surgeryLeft ventricular systolic dysfunctionArtery bypass graft surgeryLong-term clinical outcomesGreater prognostic benefitBypass graft surgeryVentricular systolic dysfunctionEffect of CABGMultivariable CoxSTICH trialGraft surgeryPrognostic benefitArtery diseaseCoronary diseaseEjection fractionHeart failureClinical outcomesSeverity of Remodeling, Myocardial Viability, and Survival in Ischemic LV Dysfunction After Surgical Revascularization
Bonow RO, Castelvecchio S, Panza JA, Berman DS, Velazquez EJ, Michler RE, She L, Holly TA, Desvigne-Nickens P, Kosevic D, Rajda M, Chrzanowski L, Deja M, Lee KL, White H, Oh JK, Doenst T, Hill JA, Rouleau JL, Menicanti L, Investigators S. Severity of Remodeling, Myocardial Viability, and Survival in Ischemic LV Dysfunction After Surgical Revascularization. JACC Cardiovascular Imaging 2015, 8: 1121-1129. PMID: 26363840, PMCID: PMC4633018, DOI: 10.1016/j.jcmg.2015.03.013.Peer-Reviewed Original ResearchMeSH KeywordsAgedCoronary Artery BypassCoronary Artery DiseaseEchocardiography, StressFemaleHumansKaplan-Meier EstimateMaleMiddle AgedMyocardiumPredictive Value of TestsProportional Hazards ModelsProspective StudiesRecovery of FunctionRisk FactorsStroke VolumeTime FactorsTissue SurvivalTomography, Emission-Computed, Single-PhotonTreatment OutcomeUnited StatesVentricular Dysfunction, LeftVentricular Function, LeftVentricular RemodelingConceptsEnd-systolic volume indexEnd-systolic volumeEffect of CABGIschemic LV dysfunctionMedical therapyMyocardial viabilityLV dysfunctionViable myocardiumLV end-systolic volume indexMedian end-systolic volume indexSmaller end-systolic volumeCoronary artery bypassLV systolic dysfunctionMarker of severityCoronary artery diseaseLeft ventricular remodelingPre-specified criteriaSingle photon emissionSTICH trialSurgical revascularizationArtery bypassDobutamine echocardiographySystolic dysfunctionArtery diseaseIschemic cardiomyopathyInfluence of Baseline Characteristics, Operative Conduct, and Postoperative Course on 30-Day Outcomes of Coronary Artery Bypass Grafting Among Patients With Left Ventricular Dysfunction
Wrobel K, Stevens SR, Jones RH, Selzman CH, Lamy A, Beaver TM, Djokovic LT, Wang N, Velazquez EJ, Sopko G, Kron IL, DiMaio JM, Michler RE, Lee KL, Yii M, Leng CY, Zembala M, Rouleau JL, Daly RC, Al-Khalidi HR. Influence of Baseline Characteristics, Operative Conduct, and Postoperative Course on 30-Day Outcomes of Coronary Artery Bypass Grafting Among Patients With Left Ventricular Dysfunction. Circulation 2015, 132: 720-730. PMID: 26304663, PMCID: PMC4551105, DOI: 10.1161/circulationaha.114.014932.Peer-Reviewed Original ResearchConceptsCoronary artery diseaseCoronary artery bypassLeft ventricular dysfunctionVentricular dysfunctionArtery diseaseArtery bypassBaseline characteristicsMedical therapyOperative conductSevere left ventricular dysfunctionAtrial fibrillation/flutterSevere coronary artery diseaseLeft ventricular ejection fractionGreater operative riskSignificant preoperative predictorsCardiopulmonary bypass timeHigh-risk patientsIschemic heart failureSerious postoperative complicationsVentricular ejection fractionLeft ventricular sizeSurgical ventricular reconstructionGreater clinical benefitCABG populationSTICH trialThe MitraClip and survival in patients with mitral regurgitation at high risk for surgery: A propensity-matched comparison
Velazquez EJ, Samad Z, Al-Khalidi HR, Sangli C, Grayburn PA, Massaro JM, Stevens SR, Feldman TE, Krucoff MW. The MitraClip and survival in patients with mitral regurgitation at high risk for surgery: A propensity-matched comparison. American Heart Journal 2015, 170: 1050-1059.e3. PMID: 26542516, DOI: 10.1016/j.ahj.2015.08.004.Peer-Reviewed Original ResearchConceptsMitraClip patientsCox proportional hazards modelPropensity-matched comparisonSevere MR patientsHigh surgical riskHigh-risk patientsNon-surgical treatmentKaplan-Meier estimatesMitral regurgitation patientsProportional hazards modelSurvival benefitMedical therapySurgical riskMitral regurgitationRelative riskBaseline differencesHigh riskMR patientsHazards modelMitraClipPatientsFurther adjustmentLaboratory databasePropensity scorePatient matchingClinical characteristics and outcomes of patients with and without diabetes in the Surgical Treatment for Ischemic Heart Failure (STICH) trial
MacDonald MR, She L, Doenst T, Binkley PF, Rouleau JL, Tan R, Lee KL, Miller AB, Sopko G, Szalewska D, Waclawiw MA, Dabrowski R, Castelvecchio S, Adlbrecht C, Michler RE, Oh JK, Velazquez EJ, Petrie MC. Clinical characteristics and outcomes of patients with and without diabetes in the Surgical Treatment for Ischemic Heart Failure (STICH) trial. European Journal Of Heart Failure 2015, 17: 725-734. PMID: 26011509, PMCID: PMC4668269, DOI: 10.1002/ejhf.288.Peer-Reviewed Original ResearchConceptsIschemic Heart Failure (STICH) trialHeart Failure TrialDiabetes mellitusMedical therapyHigher LVEFSTICH trialCABG groupPrimary outcomeSurgical treatmentFailure TrialMED groupSmaller left ventricular volumesOptimal medical therapyTriple-vessel CADCoronary artery bypassOutcomes of patientsTriple vessel diseaseLeft ventricular volumeVessel CADArtery bypassCause mortalityClinical characteristicsClinical outcomesVessel diseaseCABGGenetic Variants Are Not Associated with Outcome in Patients with Coronary Artery Disease and Left Ventricular Dysfunction: Results of the Genetic Substudy of the Surgical Treatment for Ischemic Heart Failure (STICH) Trials
Feldman AM, She L, McNamara DM, Mann DL, Bristow MR, Maisel AS, Wagner DR, Andersson B, Chiariello L, Hayward CS, Hendry P, Parker JD, Racine N, Selzman CH, Senni M, Stepinska J, Zembala M, Rouleau J, Velazquez EJ, Lee KL. Genetic Variants Are Not Associated with Outcome in Patients with Coronary Artery Disease and Left Ventricular Dysfunction: Results of the Genetic Substudy of the Surgical Treatment for Ischemic Heart Failure (STICH) Trials. Cardiology 2015, 130: 69-81. PMID: 25592552, PMCID: PMC4367125, DOI: 10.1159/000368221.Peer-Reviewed Original ResearchConceptsIschemic Heart Failure (STICH) trialHeart Failure TrialSurgical treatmentFailure TrialGenetic substudyGenetic variantsCombination of deathCoronary artery bypassHeart failure populationCoronary artery diseaseLeft ventricular reconstructionPrognostic clinical variablesΒ2-adrenergic receptor geneReceptor geneArtery bypassVentricular dysfunctionCause mortalityMultivariable adjustmentArtery diseaseCardiovascular hospitalizationMedical therapyMultivariable analysisPrognostic significanceClinical variablesVentricular reconstruction
2014
Quality-of-life outcomes with coronary artery bypass graft surgery in ischemic left ventricular dysfunction: a randomized trial.
Mark DB, Knight JD, Velazquez EJ, Wasilewski J, Howlett JG, Smith PK, Spertus JA, Rajda M, Yadav R, Hamman BL, Malinowski M, Naik A, Rankin G, Harding TM, Drew LA, Desvigne-Nickens P, Anstrom KJ. Quality-of-life outcomes with coronary artery bypass graft surgery in ischemic left ventricular dysfunction: a randomized trial. Annals Of Internal Medicine 2014, 161: 392-9. PMID: 25222386, PMCID: PMC4182862, DOI: 10.7326/m13-1380.Peer-Reviewed Original ResearchConceptsIschemic left ventricular dysfunctionLeft ventricular dysfunctionCoronary artery diseaseMedical therapyVentricular dysfunctionSTICH trialArtery diseaseKansas City Cardiomyopathy Questionnaire overall summary scoreCoronary artery bypass graft surgeryGuideline-based medical therapyKansas City Cardiomyopathy QuestionnaireMultivessel coronary artery diseaseRoutine coronary artery bypassSymptomatic high-risk patientsArtery bypass graft surgeryLeft ventricular ejection fractionPrespecified secondary end pointsLife outcomesTreatment-related qualityBypass graft surgeryCoronary artery bypassMedical therapy groupSecondary end pointsHigh-risk patientsVentricular ejection fraction