Ambrosy AP, et al. – Given the strong evidence suggesting that surgical revascularization vs medical therapy (MED) alone may improve survival in patients with heart failure (HF) of ischemic etiology and an ejection fraction (EF) ≤ 35%, researchers studied how the burden of medical comorbidities may influence these benefit in this study. Study participants included adults with coronary artery disease amenable to coronary artery bypass grafting (CABG) and an EF ≤ 35%. These participants were randomized in a 1:1 manner to receive MED (n = 602) or MED/CABG (n=610). Observations revealed a severe burden of medical comorbidities at baseline in > 70% of patients, which was independently associated with increased risk of death. No differential benefit of surgical revascularization was evident with respect to survival based on severity of comorbidity.