Coronary Revascularization and Long-Term Survivorship in Chronic Coronary Syndrome
Gabaldon-Perez, Ana (Hospital Clínic i Provincial de Barcelona)
Marcos-Garces, Victor (Hospital Clínic i Provincial de Barcelona)
Gavara Doñate, Jose (Universitat Politècnica de València. Centro de Biomateriales e Ingeniería Tisular)
Rios-Navarro, Cesar (Instituto de Investigación Sanitaria INCLIVA (València, Comunitat Valenciana))
Miñana, Gema (Universitat de València. Departament de Medicina)
Bayés-Genís, Antoni (Institut Germans Trias i Pujol. Hospital Universitari Germans Trias i Pujol)
Husser, Oliver (St. Johannes Hospital(Alemania))
Sanchis, Juan (Universitat de València. Departament de Medicina)
Núñez, Julio (Universitat de València. Departament de Medicina)
Chorro, Francisco J (Universitat de València. Departament de Medicina)
Bodi, Vicente (Universitat de València. Departament de Medicina)
Universitat Autònoma de Barcelona. Departament de Medicina

Date:	2021
Abstract:	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.
Grants:	Instituto de Salud Carlos III PI20/00637 Instituto de Salud Carlos III PI17/01836 Ministerio de Economía y Competitividad 16/11/00486 Ministerio de Economía y Competitividad 16/11/00420
Rights:	Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original.
Language:	Anglès
Document:	Article ; recerca ; Versió publicada
Subject:	Ischemic heart disease ; Chronic coronary syndrome ; Coronary artery disease ; Myocardial revascularization ; Ischemia ; Stress cardiac magnetic resonance
Published in:	Journal of clinical medicine, Vol. 10 (february 2021) , ISSN 2077-0383

DOI: 10.3390/jcm10040610
PMID: 33562869

19 p, 3.0 MB

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Research literature > UAB research groups literature > Research Centres and Groups (research output) > Health sciences and biosciences > Institut d'Investigació en Ciencies de la Salut Germans Trias i Pujol (IGTP)
Articles > Research articles
Articles > Published articles