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2021 ACC/AHA/SCAT Guideline for Coronary Artery Revascularization

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ELSEVIER SCIENCE INC
DOI: 10.1016/j.jacc.2021.09.006

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ACC/AHA Clinical Practice Guidelines; percutaneous coronary intervention; angioplasty; coronary artery bypass graft 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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This article introduces the importance and application of coronary artery revascularization guidelines, which provide a patient-centric approach for treating patients with significant coronary artery disease. The guidelines are supported by relevant literature.
AIM The guideline for coronary artery revascularization replaces the 2011 coronary artery bypass graft surgery and the 2011 and 2015 percutaneous coronary intervention guidelines, providing 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 Coronary artery disease remains a leading cause of morbidity and mortality globally. Coronary revascularization is an important therapeutic option when managing patients with coronary artery disease. The 2021 coronary artery revascularization guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with coronary artery disease who are being considered for coronary revascularization, with the intent to improve quality of care and align with patients' interests.

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