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The Best Approach for Patients with Stable Coronary Disease: The Importance of a Multidisciplinary Heart Team

Alexandru Oprea, Adrian Molnar, Sergiu Turturica

    Chirurgia (Bucharest, Romania : 1990)
    |November 3, 2020
    PubMed

    Insights

    A multidisciplinary Heart Team (HT) approach is crucial for managing stable coronary artery disease (CAD). This strategy ensures optimal patient care by preventing specialty biases and guiding therapeutic decisions effectively.

    Area of Science:

    • Cardiology
    • Interventional Cardiology
    • Cardiac Surgery

    Background:

    • Stable coronary artery disease (CAD) management benefits from a multidisciplinary Heart Team (HT) approach.
    • The HT facilitates comprehensive patient assessment and selection of optimal therapeutic strategies.
    • This study investigates the efficacy of the HT in guiding treatment decisions for stable CAD.

    Purpose of the Study:

    • To evaluate the role of the Heart Team (HT) in selecting the best therapeutic strategies for patients with stable coronary artery disease (CAD).
    • To assess the impact of HT-driven decisions on patient outcomes.
    • To highlight the importance of interdisciplinary collaboration in managing CAD.

    Main Methods:

    • A study involving 200 patients with stable coronary artery disease.
    • Weekly Heart Team (HT) meetings for open discussion and consideration of the latest therapies.
    • Treatment options included medical therapy (MT), percutaneous coronary intervention (PCI), or coronary artery bypass grafting (CABG).
    • Assessment of 1-, 3-, and 6-month outcomes post-HT implementation.

    Main Results:

    • Heart Team (HT) strategies implemented: 46% PCI, 10% CABG, 44% MT.
    • Patients undergoing surgical treatment (CABG) were more likely to have multi-vessel coronary disease (p=0.011).
    • Six-month survival rates: 96.8% for PCI, 95% for CABG, and 94.2% for MT.

    Conclusions:

    • Multidisciplinary Heart Team (HT) decision-making is essential for optimal patient care in stable coronary artery disease (CAD).
    • The HT approach helps prevent individual specialty biases in treatment selection.
    • Tertiary care institutions should implement interdisciplinary protocols for common CAD cases.

    Keywords:
    heartteammultidisciplinarydecisionstablecoronaryarterydiseasetherapeuticstrategy

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