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Review
. 2025 Dec;13(12):102731.
doi: 10.1016/j.jchf.2025.102731.

Management of Ischemic Heart Disease in Patients With Heart Failure: JACC: Heart Failure Position Statement

Lisa M Mielniczuk  1 , Tariq Ahmad  2 , Josip Andelo Borovac  3 , Kemar Brown  4 , Lauren B Cooper  5 , Nadia Fida  6 , Judith S Hochman  7 , Rasha Al Lamee  8 , Jennifer S Lawton  9 , Nikhil Narang  10 , Divaka Perera  11 , Mark C Petrie  12 , Navin Rajagopalan  13 , Nosheen Reza  14 , Peter H Stone  15 , Jacqueline Tamis-Holland  16 , Eric J Velazquez  2
Affiliations
Review

Management of Ischemic Heart Disease in Patients With Heart Failure: JACC: Heart Failure Position Statement

Lisa M Mielniczuk et al. JACC Heart Fail. 2025 Dec.

Abstract

Coronary artery disease remains a common cause of morbidity and mortality for patients with heart failure, both in the acute and chronic settings. The management decisions for these patients are complex and are often driven by the clinical setting (ie, acute vs chronic disease) and predominant symptoms (angina vs heart failure). However, there remain significant gaps in the knowledge/evidence around optimal timing and implementation of medical therapy and the role and selection of patients for revascularization. Suggested considerations for clinical practice are provided based on the current body of evidence with emphasis on ongoing gaps in knowledge for future clinical research in this area.

Keywords: cardiac imaging; coronary artery disease; heart failure; revascularization.

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Conflict of interest statement

Funding Support and Author Disclosures Dr Mielniczuk has received consulting fees from AstraZeneca, GlaxoSmithKline, and Janssen, none of which are related to this work. Dr Ahmad has received research funding from AstraZeneca, Boehringer Ingelheim, and Amgen; and consulting feeds from Edwards Biosciences, Boehringer Ingelheim, and Novo Nordisk, none of which are related to this work. Dr Borovac has received honorarium fees and research support grants from Boehringer Ingelheim and Novartis, none of which are related to this work. Dr Fida has participated in grant study sponsored by CVRx through ACCF. Dr Cooper has received research consulting fees from Abiomed and Tosoh, none related to this work. Dr Al Lamee has received grant support from the British Heart Foundation; personal fees from Abbott Vascular, Fondazione Internazionale Menarini, Shockwave, Cathworks, Medtronic, Philips, and Servier Pharmaceuticals; and board participation for Janssen Pharmaceuticals and Cathworks. Dr Petrie has received research funding from Boehringer Ingelheim, Roche, SQ Innovations, AstraZeneca, Novartis, Novo Nordisk, Medtronic, Boston Scientific, and Pharmacosmos; and performed consultancy and served on trial committees for Abbott, Akero, Applied Therapeutics, Amgen, AnaCardio, Biosensors, Boehringer Ingelheim, Corteria, Novartis, AstraZeneca, Novo Nordisk, Abbvie, Bayer, Horizon Therapeutics, Foundry, Takeda, Cardiorentis, Pharmacosmos, Siemens, Eli Lilly, Vifor, New Amsterdam, Moderna, Teikoku, LIB Therapeutics, 3R Lifesciences, Reprieve, FIRE 1, Corvia, and Regeneron. Dr Reza has received speaking honoraria from Zoll Inc; research grants to her institution from Bristol Myers Squibb Inc; and consulting fees from Roche Diagnostics, American Regent, Bristol Myers Squibb, AstraZeneca, and Idorsia, none of which are related to this work. Dr Reza is supported by the National Heart, Lung, and Blood Institute of the National Institutes of Health under Award Number K23HL166961. The content is solely the responsibility of the author and does not necessarily represent the official views of the National Institutes of Health. Dr Narang has received speaker honoraria from Boehringer Ingelheim and AstraZeneca; and consulting fees from BridgeBio. Dr Rajagopalan has served as a consultant for Abbott Laboratories. Dr Stone is supported by the National Heart, Lung, and Blood Institute (R01 HL146144-01A1 and R01 HL140498). Dr Velazquez has received consulting fees from REDNVIA Ltd and Baim, none of which are related to this work. All other authors have reported that they have no relationships relevant to the contents of this paper to disclose.

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