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Association Between Haptoglobin Phenotype and Microvascular Obstruction in Patients With STEMI: A Cardiac Magnetic Resonance Study An open-Label, 2 × 2 factorial, randomized controlled trial to evaluate the safety of apixaban vs. vitamin K antagonist and aspirin vs. placebo in patients with atrial fibrillation and acute coronary syndrome and/or percutaneous coronary intervention: Rationale and design of the AUGUSTUS trial Statin Safety and Associated Adverse Events: A Scientific Statement From the American Heart Association Better Prognosis After Complete Revascularization Using Contemporary Coronary Stents in Patients With Chronic Kidney Disease Management of Patients With NSTE-ACS: A Comparison of the Recent AHA/ACC and ESC Guidelines Utility and Challenges of an Early Invasive Strategy in Patients Resuscitated From Out-of-Hospital Cardiac Arrest Homeostatic Chemokines and Prognosis in Patients With Acute Coronary Syndromes Radionuclide Image-Guided Repair of the Heart A Novel Familial Cardiac Arrhythmia Syndrome with Widespread ST-Segment Depression Invasive Coronary Physiology After Stent Implantation: Another Step Toward Precision Medicine
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EditorialSeptember 2017, [Online First]

JOURNAL：JAMA Cardiol. Article Link

Left Main Revascularization in 2017 Coronary Artery Bypass Grafting or Percutaneous Coronary Intervention?

Ajay J. Kirtane, Robert O. Bonow Keywords: Revascularization; CABG; PCI

ABSTRACT

It can be argued that severe left main coronary artery (LMCA) disease represents the only anatomic subtype of coronary artery disease for which there is clear and unequivocal prognostic evidence in favor of coronary revascularization across the spectrum of clinical presentation—from stable ischemic heart disease to acute coronary syndrome. For decades, the standard approach to LMCA revascularization has been through coronary artery bypass grafting (CABG) given its ability to safely and effectively achieve complete revascularization. More recently, revascularization through percutaneous coronary intervention (PCI) has been proposed as an alternative to CABG for traditionally surgical anatomy. Predicate data from the Synergy Between Percutaneous Coronary Intervention with Taxus and Cardiac Surgery (SYNTAX) clinical trial and other clinical trials have suggested that the LMCA may be ideally suited to maximize the potential relative benefits of PCI (less invasiveness, ideally suited for larger vessels with more focal disease) while mitigating its relative disadvantages (restenosis and stent thrombosis, especially when tackling diffuse disease). However, until recently, the prospective evidence base on which this assertion was based was limited.
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