Purpose: Myocardial viability tests have been proposed as a key factor in the decision-making process to indicate coronary revascularization procedures in patients with left ventricular dysfunction and coronary artery disease (LVD-CAD). In order to evaluate the level of evidence to support this approach we performed a systematic review of the published literature to carry out a meta-analysis of studies that compare medical treatment (medical TX) with coronary bypass surgery (CABG) or

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... s coronary intervention (PCI) in patients with viable and non-viable myocardium. Methods: Eligible studies had to fulfil the following criteria to be included: (1) patients with LVD-CAD or previous myocardial infarction (2) myocardial viability test assessment (3) revascularization procedures (CABG or PCI) and medical treatments groups and (4) cardiac death or total mortality as the outcome Results: 32 non-randomized (4328 patients) and 4 randomized (1079 patients) studies were included in the analyses (total 5407 patients). No qualitative interaction between the groups of patients with or without myocardium viable was observed, either in non-randomized or in randomized studies (Figure 1 ).