CBS 2019
CBSMD教育中心
English

科学研究

科研文章

荐读文献

A prospective natural-history study of coronary atherosclerosis Double kissing crush in left main coronary bifurcation lesions: A crushing blow to the rival stenting techniques Digital learning and the future cardiologist Select Drug-Drug Interactions With Direct Oral Anticoagulants Screening for Cardiovascular Disease Risk With Electrocardiography: US Preventive Services Task Force Recommendation Statement Non-cardiac surgery in patients with coronary artery disease: risk evaluation and periprocedural management Update on Prevention of Cardiovascular Disease in Adults With Type 2 Diabetes Mellitus in Light of Recent Evidence: A Scientific Statement From the American Heart Association and the American Diabetes Association Quantitative Assessment of Coronary Microvascular Function: Dynamic Single-Photon Emission Computed Tomography, Positron Emission Tomography, Ultrasound, Computed Tomography, and Magnetic Resonance Imaging Plaque progression assessed by a novel semi-automated quantitative plaque software on coronary computed tomography angiography between diabetes and non-diabetes patients: A propensity-score matching study Transverse partial stent ablation with rotational atherectomy for suboptimal culotte technique in left main stem bifurcation

Review ArticleVolume 73, Issue 8, March 2019

JOURNAL:J Am Coll Cardiol. Article Link

PCI and CABG for Treating Stable Coronary Artery Disease

T Doenst, A Haverich, P Serruys et al. Keywords: heart team; prognosis; survival benefit

ABSTRACT


Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are considered revascularization procedures, but only CABG can prolong life in stable coronary artery disease. Thus, PCI and CABG mechanisms may differ. Viability and/or ischemia detection to guide revascularization have been unable to accurately predict treatment effects of CABG or PCI, questioning a revascularization mechanism for improving survival. By contrast, preventing myocardial infarction may save lives. However, the majority of infarcts are generated by non–flow-limiting stenoses, but PCI is solely focused on treating flow-limiting lesions. Thus, PCI cannot be expected to significantly limit new infarcts, but CABG may do so through providing flow distal to vessel occlusions. All comparisons of CABG to PCI or medical therapy that demonstrate survival effects with CABG also demonstrate infarct reduction. Thus, CABG may differ from PCI by providing “surgical collateralization,” prolonging life by preventing myocardial infarctions. The evidence is reviewed here.