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Current trends in coronary revascularization

Shannon M Dunlay1, Charanjit S Rihal, Thoralf M Sundt

  • 1Véronique L. Roger, MD, MPH Department of Health Sciences Research, Mayo Clinic, 200 First Street SW, Rochester, MN 55905, USA. roger.veronique@mayo.edu.

Current Treatment Options in Cardiovascular Medicine
|January 15, 2009
PubMed

Insights

Percutaneous coronary intervention (PCI) use has risen, while coronary artery bypass grafting (CABG) has declined, with historical disparities narrowing. The ongoing debate on PCI versus CABG appropriateness continues amid evolving factors.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology

Background:

  • Coronary revascularization options expanded with bare-metal and drug-eluting stents.
  • Percutaneous coronary intervention (PCI) use increased, while coronary artery bypass grafting (CABG) decreased.

Purpose of the Study:

  • To analyze trends in PCI versus CABG utilization.
  • To examine factors influencing the choice between PCI and CABG.
  • To assess the narrowing of historical disparities in revascularization procedures.

Main Methods:

  • Analysis of trends in coronary revascularization procedures.
  • Review of factors influencing procedural choices and utilization.
  • Examination of demographic trends in patients undergoing revascularization.

Main Results:

  • PCI rates have increased, whereas CABG rates have decreased.
  • Historical disparities in revascularization use among women, elderly, and nonwhite patients appear to be narrowing.
  • The optimal choice between PCI and CABG remains debated, influenced by patient anatomy, function, and comorbidities.

Conclusions:

  • The trend of increased PCI use over CABG may continue, but is subject to multiple influencing factors.
  • Ongoing evaluation of clinical evidence, technology, guidelines, and reimbursement is necessary.
  • The debate on PCI versus CABG appropriateness persists in clinical practice.

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