Revascularization Versus Medical Treatment in Patients With Ischemic Left Ventricular Dysfunction

This trial is comparing two strategies for people with heart failure and reduced pumping function caused by blocked coronary arteries (ischemic cardiomyopathy): one group will receive a procedure to open the blocked arteries (using a stent, called PCI), while the other group will receive optimised medications only. The goal is to see which approach leads to better outcomes. **You may be eligible if...** - You are 19 years or older - You have heart failure with a left ventricular ejection fraction below 40% (meaning your heart pumps less than 40% of its blood with each beat) - You have significantly narrowed coronary arteries confirmed by physiologic testing (causing reduced blood flow to the heart muscle) - The blockages in your arteries are suitable for stenting (PCI) - Your heart muscle is still viable (not all scarred) **You may NOT be eligible if...** - You have had a heart attack within the past 4 weeks - Your heart muscle is entirely scarred or not viable - You need a heart assist device or heart transplant immediately - You have a severe allergy to contrast dye (anaphylaxis) - You are pregnant or breastfeeding - You have a life expectancy of less than 2 years from other causes Talk to your doctor to see if this trial is right for you.