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Appropriate coronary artery bypass grafting use in the percutaneous coronary intervention era: are we finally making
Ruben L J Osnabrugge1, Stuart J Head, Ad J J C Bogers
1Department of Cardio-Thoracic Surgery, Erasmus University Medical Center, Thoraxcenter, Rotterdam, The Netherlands.
Abstract:
Appropriate use criteria integrate guidelines, clinical trial evidence, and expert opinion in order to determine the most appropriate care for a range of distinct clinical scenarios. Inappropriate use estimates cannot be neglected. Approximately 12%-14% of all percutaneous coronary interventions and 1%-2% of all coronary artery bypass grafting procedures in patients with stable angina are deemed inappropriate. Several reasons for this difference are identified. Continuous improvement of the criteria, multidisciplinary discussions, and the correct financial incentives will be essential in reducing the number of inappropriate procedures, improve patient outcomes, and contain costs.
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