Current concepts in coronary artery revascularisation

Area of Science:

• Cardiology
• Interventional Cardiology
• Cardiac Surgery

Background:

• Coronary artery revascularisation is a key treatment for obstructive coronary artery disease.
• Surgical revascularisation involves higher procedural risk and longer recovery than percutaneous interventions.
• Despite benefits in reducing recurrent cardiac events, current data predominantly represent specific demographics and regions.

Purpose of the Study:

• To review the current landscape of coronary artery revascularisation.
• To highlight the comparative risks and benefits of surgical versus percutaneous approaches.
• To identify critical gaps in existing research regarding diverse patient populations and global contexts.

Main Methods:

• Review of existing literature on coronary artery revascularisation.
• Comparison of outcomes between surgical and percutaneous interventions.
• Analysis of patient selection criteria, including clinical, anatomical, and preference-based factors.

Main Results:

• Surgical revascularisation offers long-term reduction in recurrent cardiac events but carries higher procedural risk and recovery time.
• Percutaneous interventions present a lower-risk alternative with faster recovery.
• Medical therapy alone may be a viable option for select patient subsets.
• Existing research is heavily biased towards White, non-elderly, male populations in high-income countries.

Conclusions:

• Patient choice, clinical presentation, and anatomical factors guide revascularisation decisions.
• Medical therapy is an essential component of care and may be sufficient in specific cases.
• Urgent need exists for comprehensive data on revascularisation outcomes in women, older adults, minorities, and low- to middle-income countries.