Patients with CAD and LV dysfunction were assigned to either medical therapy alone or medical therapy plus CABG. At 5 years, there was no significant difference between the two study groups in the rate of death from any cause. It is estimated that 5.8 million patients in the United States 1 and 15 million in Europe 2 have heart failure. Coronary artery disease is the most common substrate for heart failure in industrialized nations. 3 However, the role of coronary-artery bypass grafting (CABG) in the treatment of patients with coronary artery disease and heart failure has not been clearly established. In three landmark clinical trials in the 1970s, a total of 2234 patients with chronic stable angina were randomly assigned to undergo CABG or receive medical therapy alone. 4 – 6 The findings from these trials led to recommendations supporting the use of CABG . . .