Improving Terminology to Describe Coronary Artery Procedures: JACC Review Topic of the Week

Area of Science:

• Cardiology
• Medical Terminology
• Clinical Practice

Background:

• Coronary artery disease (CAD) management includes medical therapy, percutaneous coronary intervention (PCI), and coronary artery bypass grafting (CABG).
• PCI and CABG are often grouped under the term "myocardial revascularization."
• This umbrella term may oversimplify the distinct physiological effects of these invasive procedures.

Purpose of the Study:

• To critically evaluate the appropriateness of the term "myocardial revascularization" for PCI and CABG.
• To propose an alternative, more descriptive terminology for invasive CAD treatments.
• To enhance clinical decision-making and guide future research in cardiovascular interventions.

Main Methods:

• Review of current evidence on the mechanisms and effects of PCI and CABG.
• Analysis of the implications of terminology on understanding treatment outcomes.
• Comparative assessment of "myocardial revascularization" versus descriptive terms.

Main Results:

• The term "myocardial revascularization" inaccurately suggests a singular effect (restoring blood flow to ischemic tissue).
• It obscures crucial mechanisms like improved coronary flow without ischemia, reperfusion during ischemia, and prevention of myocardial infarction.
• PCI and CABG encompass a broader range of therapeutic benefits than implied by "myocardial revascularization."

Conclusions:

• The term "myocardial revascularization" is inappropriate for describing PCI and CABG.
• A purely descriptive terminology, such as "invasive treatment by PCI or CABG," is recommended.
• Adopting precise terminology can improve clinical decision-making and inform future trial designs for CAD interventions.