scholarly journals 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Circulation ◽  
2021 ◽  
Author(s):  
Jennifer S. Lawton ◽  
Jacqueline E. Tamis-Holland ◽  
Sripal Bangalore ◽  
Eric R. Bates ◽  
Theresa M. Beckie ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Therapeutic Option ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Significant Coronary Artery Disease ◽  
Heart Association ◽  
Coronary Artery Revascularization ◽  
Artery Disease

Aim: The guideline for coronary artery revascularization replaces the 2011 coronary artery bypass graft surgery and the 2011 and 2015 percutaneous coronary intervention guidelines, providing a patient-centric approach to guide clinicians in the treatment of patients with significant coronary artery disease undergoing coronary revascularization as well as the supporting documentation to encourage their use. Methods: A comprehensive literature search was conducted from May 2019 to September 2019, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, CINHL Complete, and other relevant databases. Additional relevant studies, published through May 2021, were also considered. Structure: Coronary artery disease remains a leading cause of morbidity and mortality globally. Coronary revascularization is an important therapeutic option when managing patients with coronary artery disease. The 2021 coronary artery revascularization guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with coronary artery disease who are being considered for coronary revascularization, with the intent to improve quality of care and align with patients’ interests.

EFFECT OF PHYSICIAN SPECIALTY ON TREATMENT RECOMMENDATION TO PATIENTS WITH CORONARY ARTERY DISEASE

2000 ◽  
Vol 16 (1) ◽  
pp. 190-198 ◽  
Author(s):  
Joseph McDonnell ◽  
Annejet P. Meijler ◽  
James P. Kahan ◽  
Henk Rigter ◽  
Steven J. Bernstein
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Clinical Decision Making ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Significant Coronary Artery Disease ◽  
Clinical Decision ◽  
Treatment Recommendation ◽  
Physician Specialty ◽  
Artery Disease

Objective: To assess the influence of physician specialty and the way in which patient data are presented in the treatment recommended for patients with coronary artery disease.Methods: In a prospective study, 3,628 patients with significant coronary artery disease who had been referred to 1 of 10 heart centers in the Netherlands as possible candidates for either percutaneous transluminal coronary angioplasty (PTCA) or coronary artery bypass graft surgery (CABG) were recruited. Within each center, the recommended treatment is determined by a team consisting of cardiologists only, cardiovascular surgeons only, or cardiologists and cardiovascular surgeons (i.e., composite teams). The main outcome measures are the proportions of patients for whom PTCA, CABG, or noninvasive (medical) therapy was recommended.Results: Composite teams made 71% of recommendations, surgeon-only teams, 12%, and cardiologist-only teams, 17%. Cardiologist-only teams primarily recommended patients to PTCA, surgeon-only teams to CABG, while combined teams made more evenly distributed recommendations (p < .001). Although the patients discussed by the three types of teams were clinically different, the recommendation patterns remained significant after adjusting for these differences (p < .001). For patients with recent myocardial infarction, direct presentation of the case to the team by the referring cardiologist reduced the likelihood that CABG would be recommended.Conclusions: The treatment recommended to patients with coronary artery disease is affected by the composition of the team providing the recommendation. These findings have important implications for clinical decision making for patients with cardiovascular disease.

scholarly journals Preoperative preparation of patients with coronary artery disease and comorbidity of chronic obstructive lung disease to scheduled coronary artery bypass graft surgery

2018 ◽  
Vol 28 (3) ◽  
pp. 263-271
Author(s):  
E. D. Bazdyrev ◽  
O. M. Polikutina ◽  
Yu. S. Slepynina ◽  
S. A. Pomeshkina ◽  
E. A. Vegner ◽  
...  
Keyword(s):  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Artery Bypass Graft ◽  
Coronary Artery Bypass ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Chronic Obstructive ◽  
Artery Bypass Graft ◽  
Artery Disease

We aimed to assess an impact of different prehabilitation schemes on a risk of postoperative cardiorespiratory complications after coronary artery bypass graft surgery (CABG) in patients with coronary artery disease (CAD) and comorbid chronic obstructive pulmonary disease (COPD). Methods. Two groups of patients with CAD and comorbid COPD who were planned for CABG were recruited in the study using the pairwise testing. A criterion of difference was the treatment with tiotropium/olodaterol (Tio/Olo) as one of prehabilitation components. An occurrence of postoperative cardiorespiratory complications was analyzed according to prehabilitation schemes used. Results. The patients with CAD + COPD treated with Tio/Olo during 12.4 ± 5.4 days prior to CABG surgery demonstrated improvement in clinical and laboratory parameters characterizing the severity of COPD just before surgical coronary revascularization. A risk of postoperative cardiovascular and respiratory complications was higher in patients not receiving bronchodilator therapy before the surgery. 

scholarly journals 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: Executive Summary: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

Circulation ◽  
2021 ◽  
Author(s):  
Jennifer S. Lawton ◽  
Jacqueline E. Tamis-Holland ◽  
Sripal Bangalore ◽  
Eric R. Bates ◽  
Theresa M. Beckie ◽  
...  
Keyword(s):  
Coronary Artery ◽  
American Heart ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Heart Association ◽  
Coronary Intervention ◽  
Executive Summary ◽  
Coronary Artery Revascularization ◽  
Percutaneous Coronary

Aim: The executive summary of the American College of Cardiology/American Heart Association/Society for Cardiovascular Angiography and Interventions coronary artery revascularization guideline provides the top 10 items readers should know about the guideline. In the full guideline, the recommendations replace the 2011 coronary artery bypass graft surgery guideline and the 2011 and 2015 percutaneous coronary intervention guidelines. This summary offers a patient-centric approach to guide clinicians in the treatment of patients with significant coronary artery disease undergoing coronary revascularization, as well as the supporting documentation to encourage their use. Methods: A comprehensive literature search was conducted from May 2019 to September 2019, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, CINHL Complete, and other relevant databases. Additional relevant studies, published through May 2021, were also considered. Structure: Recommendations from the earlier percutaneous coronary intervention and coronary artery bypass graft surgery guidelines have been updated with new evidence to guide clinicians in caring for patients undergoing coronary revascularization. This summary includes recommendations, tables, and figures from the full guideline that relate to the top 10 take-home messages. The reader is referred to the full guideline for graphical flow charts, supportive text, and tables with additional details about the rationale for and implementation of each recommendation, and the evidence tables detailing the data considered in the development of this guideline.

Health-related quality of life in patients with coronary artery disease after coronary revascularization

Open Medicine ◽  
2013 ◽  
Vol 8 (5) ◽  
pp. 618-626
Author(s):  
Ivan Tasić ◽  
Gordana Lazarević ◽  
Miomir Stojanović ◽  
Svetlana Kostić ◽  
Marija Rihter ◽  
...  
Keyword(s):  
Quality Of Life ◽  
Coronary Artery Disease ◽  
Coronary Artery ◽  
Coronary Revascularization ◽  
Artery Bypass ◽  
Bypass Graft ◽  
Two Dimensions ◽  
Sf 36 ◽  
Artery Disease

AbstractThe aim of this study was to investigate the quality of life (HRQoL) in coronary artery disease(CAD) patients, admitted for rehabilitation within 3 months after an acute coronary event, in relation to treatment strategy [conservative treatment without revascularization (WR), percutaneous transluminal coronary angioplasty (PTCA), coronary artery bypass graft (CABG)]. Methods: Overall 719 consecutive CAD patients were involved in the study: WR (n=170), PTCA (n=226), CABG (n=323). HRQoL was estimated using the SF-36 questionnaire for total QoL and its two dimensions for physical and mental health [physical and mental component scores (PCS, MCS)]. Sexual dysfunction was assessed using the ASEX scale. Results: Significantly higher PCS, MCS and total SF-36, but lower ASEX score, were found in men compared with women. The ASEX score was significantly affected by age. Significantly higher PCS was found in PTCA group compared with that of CABG group. In multivariate analysis a significant positive association was obtained between PCS/MCS and male sex, between regular exercise, hyperlipoproteinemia, and permanent stress. ASEX was significantly positively associated with the age, CHF and non smoking. Conclusion: The results of this study have demonstrated significantly better HRQoL in men, younger CAD patients, patients who underwent PTCA and in patients without self-reported exposition to stress.

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