29b73800ddb49d00c5a65c2918eff219 jcm-10-00610.pdf 2b49afde7b88d623f51b27fabde8d47793848aaa jcm-10-00610.pdf 87fd79491d55be187c349a65da27e91793d5ad0c0fb48c714f6db55bdb611adc jcm-10-00610.pdf Title: Coronary Revascularization and Long-Term Survivorship in Chronic Coronary Syndrome Subject: Ischemic heart disease (IHD) persists as the leading cause of death in the Western world. In recent decades, great headway has been made in reducing mortality due to IHD, based around secondary prevention. The advent of coronary revascularization techniques, first coronary artery bypass grafting (CABG) surgery in the 1960s and then percutaneous coronary intervention (PCI) in the 1970s, has represented one of the major breakthroughs in medicine during the last century. The benefit provided by these techniques, especially PCI, has been crucial in lowering mortality rates in acute coronary syndrome (ACS). However, in the setting where IHD is most prevalent, namely chronic coronary syndrome (CCS), the increase in life expectancy provided by coronary revascularization is controversial. Over more than 40 years, several clinical trials have been carried out comparing optimal medical treatment (OMT) alone with a strategy of routine coronary revascularization on top of OMT. Beyond a certain degree of symptomatic improvement and lower incidence of minor events, routine invasive management has not demonstrated a convincing effect in terms of reducing mortality in CCS. Based on the accumulated evidence more than half a century after the first revascularization procedures were used, invasive management should be considered in those patients with uncontrolled symptoms despite OMT or high-risk features related to left ventricular function, coronary anatomy, or functional assessment, taking into account the patient expectations and preferences. Keywords: ischemic heart disease; chronic coronary syndrome; coronary artery disease; myocardial revascularization; ischemia; stress cardiac magnetic resonance Author: Ana Gabaldon-Perez, Victor Marcos-Garces, Jose Gavara, Cesar Rios-Navarro, Gema Miñana, Antoni Bayes-Genis, Oliver Husser, Juan Sanchis, Julio Nunez, Francisco Javier Chorro and Vicente Bodi Creator: LaTeX with hyperref Producer: pdfTeX-1.40.21 CreationDate: Fri Feb 5 16:02:28 2021 CET ModDate: Fri Feb 5 17:22:31 2021 CET Tagged: no UserProperties: no Suspects: no Form: none JavaScript: no Pages: 19 Encrypted: no Page size: 595.276 x 841.89 pts (A4) Page rot: 0 File size: 3169347 bytes Optimized: no PDF version: 1.7 name type encoding emb sub uni object ID ------------------------------------ ----------------- ---------------- --- --- --- --------- XILSDV+VnURWPalladioL Type 1 Custom yes yes no 10 0 JUJRJW+URWPalladioL-Ital Type 1 Custom yes yes no 15 0 WEGUCP+URWPalladioL-Bold Type 1 Custom yes yes no 20 0 LXDRKZ+URWPalladioL-Roma Type 1 Custom yes yes no 24 0 XPUSBJ+TimesNewRomanPS-BoldItalicMT Type 1C WinAnsi yes yes no 32 0 BSDWLC+TimesNewRomanPSMT Type 1C WinAnsi yes yes no 35 0 MCBCCI+SourceSansRoman-Regular Type 1C Custom yes yes no 57 0 MCBCCM+SourceSansRoman.613wght Type 1C Custom yes yes no 61 0 MCBCCO+SourceSansRoman-Bold Type 1C Custom yes yes no 65 0 QSSHTV+VnURWPalladioL-Italic Type 1 Custom yes yes no 77 0 LYJVRE+URWPalladioL-BoldItal Type 1 Custom yes yes no 81 0 CNXSVA+CMSY10 Type 1 Builtin yes yes no 94 0 PDQPDH+VnURWPalladioL-BoldItalic Type 1 Custom yes yes no 104 0 POHLBL+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 115 0 POHLCM+PalatinoLinotype CID TrueType Identity-H yes yes yes 118 0 POHLCN+PalatinoLinotype TrueType WinAnsi yes yes no 124 0 POHLEO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 127 0 POHLBL+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 145 0 POHLCN+PalatinoLinotype TrueType WinAnsi yes yes no 148 0 POHLEO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 151 0 POHOCO+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 154 0 POHLBL+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 175 0 POHLCN+PalatinoLinotype TrueType WinAnsi yes yes no 178 0 POHLEO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 181 0 POHLBL+PalatinoLinotype,Bold TrueType WinAnsi yes yes no 199 0 POHLCN+PalatinoLinotype TrueType WinAnsi yes yes no 202 0 POHLEO+PalatinoLinotype,Italic TrueType WinAnsi yes yes no 205 0 POHOCO+PalatinoLinotype,BoldItalic TrueType WinAnsi yes yes no 208 0 Jhove (Rel. 1.22.1, 2019-04-17) Date: 2023-05-26 02:28:43 CEST RepresentationInformation: jcm-10-00610.pdf ReportingModule: PDF-hul, Rel. 1.12.1 (2019-04-17) LastModified: 2022-12-14 18:29:11 CET Size: 3169347 Format: PDF Version: 1.7 Status: Well-Formed and valid SignatureMatches: PDF-hul MIMEtype: application/pdf PDFMetadata: Objects: 547 FreeObjects: 1 IncrementalUpdates: 0 DocumentCatalog: PageLayout: SinglePage PageMode: UseNone Outlines: Item: Title: Chronic Coronary Syndrome: Definition and Perspective Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@44c8afef Item: Title: Surgical Revascularization: “The Great Hope” Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7b69c6ba Item: Title: Percutaneous Revascularization: “The Unfulfilled Dream” Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@46daef40 Item: Title: The Ischemia Trial: “The Déjà-Vu Reality” Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@12f41634 Item: Title: Real-Life Registries: “The Uncomfortable Truth” Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@13c27452 Item: Title: And Now What? Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@262b2c86 Children: Item: Title: Initial Assessment of CCS Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@371a67ec Item: Title: Left Ventricular Ejection Fraction Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@5ed828d Item: Title: The Need for OMT Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@50d0686 Item: Title: Revascularization and Patient Profiles Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@7a3d45bd Item: Title: Conclusions Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@1e7c7811 Item: Title: References Destination: edu.harvard.hul.ois.jhove.module.pdf.PdfSimpleObject@77ec78b9 Info: Title: Coronary Revascularization and Long-Term Survivorship in Chronic Coronary Syndrome Author: Ana Gabaldon-Perez, Victor Marcos-Garces, Jose Gavara, Cesar Rios-Navarro, Gema Miñana, Antoni Bayes-Genis, Oliver Husser, Juan Sanchis, Julio Nunez, Francisco Javier Chorro and Vicente Bodi Subject: Ischemic heart disease (IHD) persists as the leading cause of death in the Western world. In recent decades, great headway has been made in reducing mortality due to IHD, based around secondary prevention. The advent of coronary revascularization techniques, first coronary artery bypass grafting (CABG) surgery in the 1960s and then percutaneous coronary intervention (PCI) in the 1970s, has represented one of the major breakthroughs in medicine during the last century. The benefit provided by these techniques, especially PCI, has been crucial in lowering mortality rates in acute coronary syndrome (ACS). However, in the setting where IHD is most prevalent, namely chronic coronary syndrome (CCS), the increase in life expectancy provided by coronary revascularization is controversial. Over more than 40 years, several clinical trials have been carried out comparing optimal medical treatment (OMT) alone with a strategy of routine coronary revascularization on top of OMT. Beyond a certain degree of symptomatic improvement and lower incidence of minor events, routine invasive management has not demonstrated a convincing effect in terms of reducing mortality in CCS. Based on the accumulated evidence more than half a century after the first revascularization procedures were used, invasive management should be considered in those patients with uncontrolled symptoms despite OMT or high-risk features related to left ventricular function, coronary anatomy, or functional assessment, taking into account the patient expectations and preferences. 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440, 376, 477, 387 Annotation: Subtype: Link Rect: 508, 353, 545, 364 Annotation: Subtype: Link Rect: 59, 331, 97, 341 Annotation: Subtype: Link Rect: 225, 296, 262, 306 Annotation: Subtype: Link Rect: 269, 296, 305, 306 Annotation: Subtype: Link Rect: 313, 261, 351, 272 Annotation: Subtype: Link Rect: 449, 226, 486, 237 Annotation: Subtype: Link Rect: 59, 192, 97, 203 Annotation: Subtype: Link Rect: 479, 169, 516, 180 Annotation: Subtype: Link Rect: 521, 169, 557, 180 Annotation: Subtype: Link Rect: 172, 146, 209, 157 Annotation: Subtype: Link Rect: 215, 146, 251, 157 Annotation: Subtype: Link Rect: 218, 123, 256, 134 Annotation: Subtype: Link Rect: 262, 123, 298, 134 Checksum: 0ca461a1 Type: CRC32 Checksum: 29b73800ddb49d00c5a65c2918eff219 Type: MD5 Checksum: 2b49afde7b88d623f51b27fabde8d47793848aaa Type: SHA-1