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Revascularization in stable coronary artery disease: a combined perspective from an interventional cardiologist and a

David R Holmes1, David P Taggart2

  • 1Mayo Clinic College of Medicine and Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA.

European Heart Journal
|March 20, 2016
PubMed

Insights

For stable coronary artery disease, the debate continues regarding the best treatment between percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) surgery. This review clarifies current understanding and identifies remaining uncertainties.

Area of Science:

  • Cardiovascular Medicine
  • Interventional Cardiology
  • Cardiac Surgery

Background:

  • Coronary artery bypass graft (CABG) surgery has been performed for 50 years.
  • Percutaneous coronary intervention (PCI) emerged over a decade later.
  • The optimal revascularization strategy for stable coronary artery disease (stable-CAD) remains a subject of ongoing debate.

Purpose of the Study:

  • To review the comparative effectiveness of PCI versus CABG in patients with stable-CAD.
  • To identify areas of consensus and disagreement in current clinical practice guidelines.
  • To highlight unresolved questions regarding the role of PCI and CABG in stable-CAD management.

Main Methods:

  • Systematic review of randomized trials, registry studies, and meta-analyses.
  • Analysis of evidence comparing PCI and CABG for stable coronary artery disease.
  • Synthesis of findings to address clinical uncertainties.

Main Results:

  • Evidence from approximately 20 randomized trials and numerous observational studies has been evaluated.
  • Key differences and similarities in outcomes between PCI and CABG for stable-CAD have been identified.
  • Areas requiring further investigation have been pinpointed.

Conclusions:

  • The relative merits of PCI and CABG for stable-CAD continue to be debated.
  • Understanding the current evidence is crucial for informed clinical decision-making.
  • Further research is needed to definitively establish the optimal revascularization strategy in specific patient subgroups.

Keywords:
CABGMammary arteryPCIStentSurgery

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