What were the serious concerns of the committee regarding the applicability of the evidence to modern clinical management of heart failure patients in the UK?
The committee had two serious concerns about the applicability of the evidence to modern clinical management of heart failure patients in the UK. Firstly, they noted that the evidence for CABG was not generalisable to the majority of heart failure with reduced ejection fraction (HFREF) patients, as the characteristics of the patients in the trial were not representative of the HFREF population in the UK community. Secondly, they noted that there was a substantial 30 day mortality rate associated with CABG, despite the clinically important reduction in mortality evident at the extended follow-up period of 9.8 years.