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| {{Chronic stable angina}}
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| '''Editors-In-Chief:''' [[C. Michael Gibson, M.S., M.D.]] [mailto:mgibson@perfuse.org] Phone:617-632-7753; {{CZ}}; '''Associate Editors-In-Chief:''' [[John Fani Srour, M.D.]]; Smita Kohli, M.D.
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| ==ACC/AHA Guidelines- Recommendations for Revascularization with PCI and CABG in Asymptomatic Patients (DO NOT EDIT)<ref name="pmid10351980">Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM et al. (1999)[http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10351980ACC/AHA/ACP-ASIM 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: [http://pubmed.gov/10351980 10351980]</ref><ref name="pmid12515758">Gibbons RJ, Abrams J, Chatterjee K, Daley J, Deedwania PC, Douglas JS et al. (2003) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=12515758 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: [http://pubmed.gov/12515758 12515758]</ref>==
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| {{cquote|
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| ===Class I===
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| '''1.''' [[CABG]] for patients with significant left main coronary disease. ''(Level of Evidence: B)''
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| '''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)''
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| '''3.''' [[CABG]] for patients with two-vessel disease with significant proximal [[left anterior descending artery|left anterior descending]] [[CAD]] and either abnormal [[LV function]] (ejection fraction less than 50%) or demonstrable [[ischemia]] on noninvasive testing. ''(Level of Evidence: C)''
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| '''4.''' [[PCI]] for patients with two- or three-vessel disease with significant proximal [[left anterior descending artery|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)''
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| '''5.''' [[PCI]] or [[CABG]] for patients with one- or two-vessel [[CAD]] without significant proximal [[left anterior descending artery|left anterior descending]] [[CAD]] but with a large area of viable myocardium and high-risk criteria on non-invasive testing. ''(Level of Evidence: C)''
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| '''6.''' [[CABG]] for patients with one- or two-vessel [[CAD]] without significant proximal [[left anterior descending artery|left anterior descending]] [[CAD]] who have survived sudden cardiac death or sustained [[ventricular tachycardia]]. ''(Level of Evidence: C)''
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| '''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)''
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| ===Class IIa===
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| '''1.''' [[PCI]] or [[CABG]] for patients with one-vessel disease with significant proximal [[left anterior descending artery|left anterior descending]] [[CAD]]. ''(Level of Evidence: C)''
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| ===Class IIb===
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| '''1.''' Compared with [[CABG]], [[PCI]] for patients with two or three vessel disease with significant proximal [[left anterior descending artery|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)''
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| '''2.''' Use of [[PCI]] for patients with significant left main coronary disease who are not candidates for [[CABG]]. ''(Level of Evidence: C)''
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| '''3.''' [[PCI]] for patients with one or two-vessel [[CAD]] without significant proximal [[left anterior descending artery|left anterior descending]] [[CAD]] who have survived sudden cardiac death or sustained ventricular tachycardia. ''(Level of Evidence: C)''
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| '''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 [[left anterior descending artery|LAD]]. [[PCI]] may be appropriate for focal saphenous vein graft lesions or multiple stenoses in poor candidates for reoperative surgery. ''(Level of Evidence: C)''
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| '''5.''' [[PCI]] or [[CABG]] for patients with one- or two-vessel [[CAD]] without significant proximal [[left anterior descending artery|left anterior descending]] [[CAD]] but with a moderate area of viable myocardium and demonstrable [[ischemia]] on noninvasive testing. ''(Level of Evidence: C)''
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| ===Class III===
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| '''1.''' Use of [[PCI]] or [[CABG]] for patients with one- or two-vessel [[CAD]] without significant proximal [[left anterior descending artery|left anterior descending]] [[CAD]] and
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| :'''a.''' only a small area of viable myocardium or
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| :'''b.''' no demonstrable [[ischemia]] on noninvasive testing. ''(Level of Evidence: C)''
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| '''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)''
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| '''3.''' Use of [[PCI]] or [[CABG]] for patients with insignificant coronary stenosis (less than 50% diameter). ''(Level of Evidence: C)''
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| '''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==
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| *[[The Living Guidelines: Chronic Stable Angina Pectoris | The Chronic Stable Angina Living Guidelines: Vote on current recommendations and suggest revisions to the guidelines]]
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| ==Guidelines Resources==
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| *The ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina <ref name="pmid10351980">Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM et al. (1999) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=10351980 ACC/AHA/ACP-ASIM 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: [http://pubmed.gov/10351980 10351980]</ref>
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| *The ACC/AHA 2002 Guideline Update for the Management of Patients With Chronic Stable Angina <ref name="pmid12515758">Gibbons RJ, Abrams J, Chatterjee K, Daley J, Deedwania PC, Douglas JS et al. (2003) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=12515758 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: [http://pubmed.gov/12515758 12515758]</ref>
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| *The 2007 Chronic Angina Focused Update of the ACC/AHA 2002 Guidelines for the Management of Patients With Chronic Stable Angina <ref name="pmid17998462">Fraker TD, Fihn SD, Gibbons RJ, Abrams J, Chatterjee K, Daley J et al. (2007) [http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&retmode=ref&cmd=prlinks&id=17998462 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. [http://dx.doi.org/10.1161/CIRCULATIONAHA.107.187930 DOI:10.1161/CIRCULATIONAHA.107.187930] PMID: [http://pubmed.gov/17998462 17998462]</ref>
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| ==References==
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| [[Category:Disease]]
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| [[Category:Ischemic heart diseases]]
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| [[Category:Up-To-Date cardiology]]
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