4.7 Article

2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: Executive Summary

Journal

JOURNAL OF THE AMERICAN COLLEGE OF CARDIOLOGY
Volume 79, Issue 2, Pages 197-215

Publisher

ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2021.09.005

Keywords

ACC/AHA Clinical Practice Guidelines; percutaneous coronary intervention (PCI); angioplasty; coronary artery bypass graft (CABG) surgery; myocardial infarction; cardiac surgery; stent(s); angiogram; angiography; percutaneous transluminal coronary angioplasty; coronary atherosclerosis; saphenous vein graft; internal mammary artery graft; internal thoracic artery graft; arterial graft; post-bypass; non-ST-segment-elevated myocardial infarction; vein graft lesions; myocardial revascularization; multivessel PCI; left ventricular dysfunction

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The executive summary of the guideline provides top 10 key points that clinicians should know about coronary revascularization for patients with significant coronary artery disease. This summary offers a patient-centric approach and encourages the use of supporting documentation.
AIM The executive summary of the American College of Cardiology/American Heart Association/Society for Cardiovascular Angiography and Interventions coronary artery revascularization guideline provides the top 10 items readers should know about the guideline. In the full guideline, the recommendations replace the 2011 coronary artery bypass graft surgery guideline and the 2011 and 2015 percutaneous coronary intervention guidelines. This summary offers a patient-centric approach to guide clinicians in the treatment of patients with significant coronary artery disease undergoing coronary revascularization, as well as the supporting documentation to encourage their use. METHODS A comprehensive literature search was conducted from May 2019 to September 2019, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, CINHL Complete, and other relevant databases. Additional relevant studies, published through May 2021, were also considered. STRUCTURE Recommendations from the earlier percutaneous coronary intervention and coronary artery bypass graft surgery guidetines have been updated with new evidence to guide clinicians in caring for patients undergoing coronary revascularization. This summary includes recommendations, tables, and figures from the full guideline that relate to the top 10 take-home messages. The reader is referred to the full guideline for graphicalflow charts, supportive text, and tables with additional details about the rationale for and implementation of each recommendation, and the evidence tables detailing the data considered in the development of this guideline.

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