Debate. Percutaneous revascularization in dilated cardiomyopathy. Apropos of the REVIVED BCIS2 trial: the interventional cardiologist’s view

Abstract

QUESTION: What is your opinion of the REVIVED BCIS2 trial? Which, would you say, are its most positive and most debatable features? ANSWER: The REVIVED BCIS21 is a prospective, multicenter, randomized, open-label trial of stable patients with severe left ventricular dysfunction (left ventricular ejection fraction [LVEF] ≤ 35%), extensive coronary artery disease with a British Cardiovascular Intervention Society (BCIS) risk score ≥ 6, and evidence of viability in at least 4 dysfunctional segments amenable to percutaneous coronary intervention (PCI). Patients were randomized in a 1:1 ratio to receive PCI along with optimal medical therapy (OMT), or OMT alone. The OMT included pharmacological therapy and implantable devices for the management of heart failure. The primary endpoint was a composite of all-cause mortality or hospitalization over a minimum follow-up of 24 months. Secondary endpoints included 6- and 12-month echocardiographic measurements of LVEF (core lab), quality of life measurement through questionnaires such as the Kansas City Cardiomyopathy Questionnaire, the EuroQol Group 5-Dimensions 5-Level Questionnaire, and New York Heart Association Functional Class, cardiovascular death, acute myocardial infarction (AMI), appropriate defibrillator therapy (antitachycardia pacing or shock), unplanned revascularization, brain natriuretic peptide values, functional class, and major bleeding. A total of 700 patients were included, of which 347 were...