2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization
Published: December 09, 2021
- Treatment decisions with regard to coronary revascularization in patients with coronary artery disease should be based on clinical indications, regardless of sex, race, or ethnicity, because there is no evidence that some patients benefit less than others, and efforts to reduce disparities of care are warranted.
- In patients being considered for coronary revascularization for whom the optimal treatment strategy is unclear, a multidisciplinary Heart Team approach is recommended. Treatment decisions should be patient centered, incorporate patient preferences and goals, and include shared decision-making.
- Updated evidence from contemporary trials supplement older evidence with regard to mortality benefit of revascularization in patients with stable ischemic heart disease, normal left ventricular ejection fraction, and triple-vessel coronary artery disease. Surgical revascularization may be reasonable to improve survival. A survival benefit with percutaneous revascularization is uncertain. Revascularization decisions are based on consideration of disease complexity, technical feasibility of treatment, and a Heart Team discussion.
Related Resources
- AHA Clinical Update: 2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization Slide Set
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Recommended Reading
- 2015 Focused Update on Primary Percutaneous Coronary Intervention (PCI) for Patients With ST-Elevation Myocardial Infarction (STEMI): An Update of the 2011 Guideline for PCI and the 2013 Guideline for the Management of STEMI
- 2014 Guideline for the Management of Patients with Non-ST- Evaluation Acute Coronary Syndromes
- 2013 Guideline for the Management of ST-Elevation Myocardial Infarction
- 2012 Guideline for the Diagnosis and Management of Patients with Stable Ischemic Heart Disease
- 2011 Guideline for Percutaneous Coronary Intervention
- 2011 Guideline for Coronary Artery Bypass Graft Surgery
- 2018 Spontaneous Coronary Artery Dissection: Current State of the Science
- 2015 Secondary Prevention After Coronary Artery Bypass Graft Surgery