Chronic stable angina revascularization with PCI and CABG in asymptomatic patients: Difference between revisions
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Revision as of 19:37, 9 December 2011
Chronic stable angina Microchapters | ||
Classification | ||
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Differentiating Chronic Stable Angina from Acute Coronary Syndromes | ||
Diagnosis | ||
Alternative Therapies for Refractory Angina | ||
Discharge Care | ||
Guidelines for Asymptomatic Patients | ||
Case Studies | ||
Chronic stable angina revascularization with PCI and CABG in asymptomatic patients On the Web | ||
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Editors-In-Chief: C. Michael Gibson, M.S., M.D. [1] Phone:617-632-7753; Cafer Zorkun, M.D., Ph.D. [2]; Associate Editors-In-Chief: John Fani Srour, M.D.; Smita Kohli, M.D.
ACC/AHA Guidelines- Recommendations for Revascularization with PCI and CABG in Asymptomatic Patients (DO NOT EDIT)[1][2]
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Class I1. CABG for patients with significant left main coronary disease. (Level of Evidence: B) 2. CABG for patients with three-vessel disease. The survival benefit is greater in patients with abnormal LV function (ejection fraction less than 50%). (Level of Evidence: C) 3. CABG for patients with two-vessel disease with significant proximal left anterior descending CAD and either abnormal LV function (ejection fraction less than 50%) or demonstrable ischemia on noninvasive testing. (Level of Evidence: C) 4. PCI for patients with two- or three-vessel disease with significant proximal Left anterior descending CAD who have anatomy suitable for catheter based therapy and normal LV function and who do not have treated diabetes. (Level of Evidence: C) 5. PCI or CABG for patients with one- or two-vessel CAD without significant proximal left anterior descending CAD but with a large area of viable myocardium and high-risk criteria on non-invasive testing. (Level of Evidence: C) 6. CABG for patients with one- or two-vessel CAD without significant proximal left anterior descending CAD who have survived sudden cardiac death or sustained ventricular tachycardia. (Level of Evidence: C) 7. In patients with prior PCI, CABG or PCI for recurrent stenosis associated with a large area of viable myocardium or high-risk criteria on noninvasive testing. (Level of Evidence: C) Class IIa1. PCI or CABG for patients with one-vessel disease with significant proximal left anterior descending CAD. (Level of Evidence: C) Class IIb1. Compared with CABG, PCI for patients with two or three vessel disease with significant proximal left anterior descending CAD who have anatomy suitable for catheter-based therapy and who have treated diabetes or abnormal LV function. (Level of Evidence: B) 2. Use of PCI for patients with significant left main coronary disease who are not candidates for CABG. (Level of Evidence: C) 3. PCI for patients with one or two-vessel CAD without significant proximal left anterior descending CAD who have survived sudden cardiac death or sustained ventricular tachycardia. (Level of Evidence: C) 4. Repeat CABG for patients with multiple saphenous vein graft stenoses, with high-risk criteria on noninvasive testing, especially when there is significant stenosis of a graft supplying the LAD. PCI may be appropriate for focal saphenous vein graft lesions or multiple stenoses in poor candidates for reoperative surgery. (Level of Evidence: C) 5. PCI or CABG for patients with one- or two-vessel CAD without significant proximal left anterior descending CAD but with a moderate area of viable myocardium and demonstrable ischemia on noninvasive testing. (Level of Evidence: C) Class III1. Use of PCI or CABG for patients with one- or two-vessel CAD without significant proximal left anterior descending CAD and
2. Use of PCI or CABG for patients with borderline coronary stenoses (50% to 60% diameter in locations other than the left main coronary artery) and no demonstrable ischemia on noninvasive testing. (Level of Evidence: C) 3. Use of PCI or CABG for patients with insignificant coronary stenosis (less than 50% diameter). (Level of Evidence: C) 4. Use of PCI in patients with significant left main CAD who are candidates for CABG. (Level of Evidence: B) |
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See Also
Guidelines Resources
- The ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina [1]
- The ACC/AHA 2002 Guideline Update for the Management of Patients With Chronic Stable Angina [2]
- The 2007 Chronic Angina Focused Update of the ACC/AHA 2002 Guidelines for the Management of Patients With Chronic Stable Angina [3]
References
- ↑ 1.0 1.1 Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM et al. (1999)guidelines for the management of patients with chronic stable angina: executive summary and recommendations. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients with Chronic Stable Angina).Circulation 99 (21):2829-48. PMID: 10351980
- ↑ 2.0 2.1 Gibbons RJ, Abrams J, Chatterjee K, Daley J, Deedwania PC, Douglas JS et al. (2003) ACC/AHA 2002 guideline update for the management of patients with chronic stable angina--summary article: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on the Management of Patients With Chronic Stable Angina). Circulation 107 (1):149-58. PMID: 12515758
- ↑ Fraker TD, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J et al. (2007) 2007 chronic angina focused update of the ACC/AHA 2002 Guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines Writing Group to develop the focused update of the 2002 Guidelines for the management of patients with chronic stable angina. Circulation 116 (23):2762-72. DOI:10.1161/CIRCULATIONAHA.107.187930 PMID: 17998462