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With regard to circulating substrate supply, studies by Lommi and co-workers (, ) found a higher rate of plasma FFA turnover and elevated FFA concentration in heart failure patients compared with controls, which exposes the heart to a greater FFA load and could increase myocardial FFA uptake and β-oxidation through simple mass action ().

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This prompts your heart to pump faster to meet the demands placed on it but doing so causes a greater need for more oxygen.

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Parallel curves after an initial separation imply a continued benefit of treatment, because the larger number of survivors in the effective-treatment arm should result in a higher number of deaths in that group if the risk were equal, and because saving patients at higher risk in the effective-treatment arm should lead to a population at intrinsically higher risk in this group over time.

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References attached to these recommendations can be found in Table 8 of the original ESC guidelines for myocardial revascularization.

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