G. Torres-Ruiz, Nuria Mallofré-Vila, P. Rojas-Flores, Pablo Carrión-Montaner, E. Bosch-Peligero, Daniel Valcárcel-Paz, Ada Cardiel-Perez, J. Guindo-Soldevila, Antonio Martínez-Rubio
{"title":"左冠状动脉主干疾病的循证管理","authors":"G. Torres-Ruiz, Nuria Mallofré-Vila, P. Rojas-Flores, Pablo Carrión-Montaner, E. Bosch-Peligero, Daniel Valcárcel-Paz, Ada Cardiel-Perez, J. Guindo-Soldevila, Antonio Martínez-Rubio","doi":"10.15420/ecr.2023.36","DOIUrl":null,"url":null,"abstract":"Left main coronary artery disease (LMCAD) is associated with high morbidity and mortality due to the large myocardial mass at risk. Although medical treatment may be an option in selected low-risk patients, revascularisation is recommended to improve survival in the majority of patients presenting with a significant left main stenosis. In the past decade, multiple randomised clinical trials and meta-analyses have compared coronary artery bypass grafting surgery (CABG) versus percutaneous coronary intervention (PCI), finding controversial results. The strategy for LMCAD revascularisation is still challenging. Coronary anatomy complexity, clinical features and patient preferences are key elements to be considered by the heart team. The current guidelines define CABG as standard therapy, but the continuous improvements in PCI techniques, the use of intracoronary imaging and functional assessment make PCI a feasible alternative in selected patients, particularly in those with comorbidities and contraindications to CABG. This review analyses the most important studies comparing CABG versus PCI in patients with LMCAD.","PeriodicalId":45957,"journal":{"name":"European Cardiology Review","volume":null,"pages":null},"PeriodicalIF":3.2000,"publicationDate":"2023-12-19","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":"{\"title\":\"Evidence-based Management of Left Main Coronary Artery Disease\",\"authors\":\"G. Torres-Ruiz, Nuria Mallofré-Vila, P. Rojas-Flores, Pablo Carrión-Montaner, E. Bosch-Peligero, Daniel Valcárcel-Paz, Ada Cardiel-Perez, J. Guindo-Soldevila, Antonio Martínez-Rubio\",\"doi\":\"10.15420/ecr.2023.36\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"Left main coronary artery disease (LMCAD) is associated with high morbidity and mortality due to the large myocardial mass at risk. Although medical treatment may be an option in selected low-risk patients, revascularisation is recommended to improve survival in the majority of patients presenting with a significant left main stenosis. In the past decade, multiple randomised clinical trials and meta-analyses have compared coronary artery bypass grafting surgery (CABG) versus percutaneous coronary intervention (PCI), finding controversial results. The strategy for LMCAD revascularisation is still challenging. Coronary anatomy complexity, clinical features and patient preferences are key elements to be considered by the heart team. The current guidelines define CABG as standard therapy, but the continuous improvements in PCI techniques, the use of intracoronary imaging and functional assessment make PCI a feasible alternative in selected patients, particularly in those with comorbidities and contraindications to CABG. This review analyses the most important studies comparing CABG versus PCI in patients with LMCAD.\",\"PeriodicalId\":45957,\"journal\":{\"name\":\"European Cardiology Review\",\"volume\":null,\"pages\":null},\"PeriodicalIF\":3.2000,\"publicationDate\":\"2023-12-19\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"European Cardiology Review\",\"FirstCategoryId\":\"1085\",\"ListUrlMain\":\"https://doi.org/10.15420/ecr.2023.36\",\"RegionNum\":0,\"RegionCategory\":null,\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"\",\"PubModel\":\"\",\"JCR\":\"Q2\",\"JCRName\":\"CARDIAC & CARDIOVASCULAR SYSTEMS\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"European Cardiology Review","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.15420/ecr.2023.36","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"CARDIAC & CARDIOVASCULAR SYSTEMS","Score":null,"Total":0}
Evidence-based Management of Left Main Coronary Artery Disease
Left main coronary artery disease (LMCAD) is associated with high morbidity and mortality due to the large myocardial mass at risk. Although medical treatment may be an option in selected low-risk patients, revascularisation is recommended to improve survival in the majority of patients presenting with a significant left main stenosis. In the past decade, multiple randomised clinical trials and meta-analyses have compared coronary artery bypass grafting surgery (CABG) versus percutaneous coronary intervention (PCI), finding controversial results. The strategy for LMCAD revascularisation is still challenging. Coronary anatomy complexity, clinical features and patient preferences are key elements to be considered by the heart team. The current guidelines define CABG as standard therapy, but the continuous improvements in PCI techniques, the use of intracoronary imaging and functional assessment make PCI a feasible alternative in selected patients, particularly in those with comorbidities and contraindications to CABG. This review analyses the most important studies comparing CABG versus PCI in patients with LMCAD.