Heart failure with reduced ejection fraction (HFrEF) still has significant morbidity and mortality despite the advancements in medical and device therapy (1). In the West, the most common cause of left ventricular dysfunction is coronary artery disease (CAD) (1). The management of patients with severe left ventricular systolic dysfunction (LVSD) and significant CAD without a clear indication for revascularisation, such as acute coronary syndrome (ACS) or angina, has divided cardiology opinion.
