Coronary Revascularization and Long-Term Survivorship in Chronic Coronary Syndrome
Por:
Gabaldon-Perez, A, Marcos-Garces, V, Gavara, J, Rios-Navarro, C, Minana, G, Bayes-Genis, A, Husser, O, Sanchis, J, Nunez, J, Chorro, FJ and Bodi, V
Publicada:
1 feb 2021
Ahead of Print:
5 feb 2021
Resumen:
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.
Filiaciones:
Gabaldon-Perez, A:
Univ Valencia, Hosp Clin, Dept Cardiol, Valencia 46010, Spain
Marcos-Garces, V:
Univ Valencia, Hosp Clin, Dept Cardiol, Valencia 46010, Spain
Gavara, J:
INCLIVA Hlth Res Inst, Valencia 46010, Spain
Univ Politecn Valencia, Ctr Biomat & Tissue Engn, Valencia 46022, Spain
Rios-Navarro, C:
INCLIVA Hlth Res Inst, Valencia 46010, Spain
Minana, G:
Univ Valencia, Hosp Clin, Dept Cardiol, Valencia 46010, Spain
INCLIVA Hlth Res Inst, Valencia 46010, Spain
Ctr Invest Biomed Red Cardiovasc CIBER CV, Madrid 28029, Spain
Univ Valencia, Dept Med, Fac Med & Odontol, Valencia 46010, Spain
:
Ctr Invest Biomed Red Cardiovasc CIBER CV, Madrid 28029, Spain
Hosp Badalona Germans Trias & Pujol, Cardiol Dept, Badalona 08916, Spain
Hosp Badalona Germans Trias & Pujol, Heart Failure Unit, Badalona 08916, Spain
Univ Autonoma Barcelona, Dept Med, Barcelona 08193, Spain
Husser, O:
St Johannes Hosp, Dept Cardiol, D-44137 Dortmund, Germany
Sanchis, J:
Univ Valencia, Hosp Clin, Dept Cardiol, Valencia 46010, Spain
INCLIVA Hlth Res Inst, Valencia 46010, Spain
Ctr Invest Biomed Red Cardiovasc CIBER CV, Madrid 28029, Spain
Univ Valencia, Dept Med, Fac Med & Odontol, Valencia 46010, Spain
Nunez, J:
Univ Valencia, Hosp Clin, Dept Cardiol, Valencia 46010, Spain
INCLIVA Hlth Res Inst, Valencia 46010, Spain
Ctr Invest Biomed Red Cardiovasc CIBER CV, Madrid 28029, Spain
Univ Valencia, Dept Med, Fac Med & Odontol, Valencia 46010, Spain
Chorro, FJ:
Univ Valencia, Hosp Clin, Dept Cardiol, Valencia 46010, Spain
INCLIVA Hlth Res Inst, Valencia 46010, Spain
Ctr Invest Biomed Red Cardiovasc CIBER CV, Madrid 28029, Spain
Univ Valencia, Dept Med, Fac Med & Odontol, Valencia 46010, Spain
Bodi, V:
Univ Valencia, Hosp Clin, Dept Cardiol, Valencia 46010, Spain
INCLIVA Hlth Res Inst, Valencia 46010, Spain
Ctr Invest Biomed Red Cardiovasc CIBER CV, Madrid 28029, Spain
Univ Valencia, Dept Med, Fac Med & Odontol, Valencia 46010, Spain
gold, Green Published
|