Does ejection fraction matter in choosing between percutaneous coronary intervention and coronary artery bypass surgery?

Left ventricular systolic dysfunction has traditionally been used as a risk factor favoring coronary artery bypass surgery over percutaneous coronary intervention (PCI), but recent data have challenged this. Retrospective data from the BIOFLOW trials show no difference between normal and moderately abnormal LVEF (30%-50%) in acute complications or target vessel failure. Abnormal LVEF may be a marker for comorbidities but no longer a relative contraindication to PCI.