Ambrosy AP, et al. - Given the findings of the landmark STICH trial that surgical revascularization compared to medical therapy alone improved survival in patients with heart failure (HF) of ischaemic aetiology and an ejection fraction (EF) ≤ 35%, researchers assessed the interaction between the burden of medical co-morbidities and the benefit from surgical revascularization in patients with ischaemic cardiomyopathy. The study population included 349 patients (29%) with a mild/moderate Charlson co-morbidity index (CCI) score and 863 patients (71%) with a severe CCI score. After adjusting for baseline confounders, they identified a higher risk for all-cause mortality among patients with a severe CCI score. No differential benefit of surgical revascularization with respect to survival based on severity of co-morbidity was observed.