In patients with severe ischaemic left ventricular (LV) systolic dysfunction receiving optimal medical therapy (OMT), the addition of revascularization with percutaneous coronary intervention (PCI) does not reduce the incidence of death from any cause or hospitalization for heart failure, according to results from the REVIVED-BCIS2 trial presented at ESC.22. A total of 700 patients with LV ejection fraction ≤35%, extensive coronary artery disease and dysfunctional but viable myocardium were randomly assigned to PCI plus OMT or OMT alone. After a median of 41 months, the incidence of death from any cause or hospitalization for heart failure (the primary outcome) did not significantly differ between the groups (37.2% in the PCI group and 38.0% in the OMT group; HR 0.99, 95% CI 0.78–1.27, P = 0.96). Similarly, PCI did not improve LV ejection fraction at 6 or 12 months or quality of life at 24 months.