PCI With Guideline-Directed Medical Therapy for HFpEF Patients With Ischemic Cardiomyopathy

Inclusion Criteria: * Both male and female subjects aged ≥18 years at screening. * Documented LVEF ≤40% assessed by echocardiography, or cardiac magnetic resonance imaging (CMR), or ventriculography within 90 days prior to randomization. * Symptomatic heart failure (NYHA Functional Class II, III, or ambulatory class IV) * Angiographically proven CAD with at least one lesion (50\~89% stenosis by visual estimate in a major epicardial vessel ≥2.5mm in diameter, or ≥50% left main stenosis, both requiring a QFR≤0.8) considered amenable to PCI with DES by an interventional cardiologist. * On stable, optimally titrated GDMT for at least 2 weeks prior to randomization, as tolerated. This includes, at a minimum, a beta-blocker and a renin-angiotensin-aldosterone system inhibitor (ACEi/ARB/ARNI) at maximal tolerated doses. * The subject, or their legal guardian, has a clear understanding of the trial's design and procedures, provides written informed consent, and able to comply with follow-up. Exclusion Criteria: * Acute coronary syndrome (ACS) within 30 days requiring urgent/emergent revascularization. * Non-cardiac life expectancy \<1 year at screening (e.g., malignancy, advanced liver disease). * Coronary anatomy unsuitable for PCI or requiring urgent surgical revascularization (e.g., diameter stenosis ≥90%, diameter stenosis \<90% but QFR\>0.8, complex multi-vessel disease deemed better suited for coronary artery bypass grafting \[CABG\] by Heart Team). * Prior CABG. * HF due to…