We recommend consideration of coronary artery bypass surgery for patients with chronic ischemic cardiomyopathy, LVEF < 35%, graftable coronary arteries, and who are otherwise suitable candidates for surgery, irrespective of the presence of angina and HF symptoms to improve quality of life, and reduce rates of cardiovascular death and hospitalization.
(Strong Recommendation, Moderate-Quality Evidence)

We suggest consideration of PCI for patients with HF and limiting symptoms of cardiac ischemia, and for whom coronary artery bypass grafting (CABG) is not considered appropriate.
(Conditional Recommendation, Low-Quality Evidence)

We recommend against routine performance of surgical ventricular restoration for patients with HF undergoing CABG who have akinetic or dyskinetic segments.
(Strong Recommendation, Moderate-Quality Evidence)

Values and preferences: These recommendations are based on data from RCTs on CABG and surgical ventricular restoration in patients with reduced systolic function and CAD. The recommendation on PCI is based on clinical need rather than RCT trial data.