ACC/AHA 2004 guideline update for coronary artery bypass graft surgery

Wilkins, Lippincott Williams

doi:10.1016/j.jacc.2004.08.002

Cited by 82 publications

(2 citation statements)

References 777 publications

(671 reference statements)

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“…32 • Disease of the left main coronary artery (LMCA) • Three-vessel disease • Diffuse disease not amenable to treatment with PCI In patients with LMCA disease, the benefi t of surgery over medical treatment is evident. PCI is possible in selected patients with LMCA disease.…”

Section: Indications For Cabgmentioning

confidence: 99%

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Optimal treatment for coronary artery disease in patients with diabetes: percutaneous coronary intervention, coronary artery bypass graft, and medications

Ito

2011

Gen Thorac Cardiovasc Surg

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There are three strategies for patients with coronary artery disease (CAD): medical therapy, coronary artery bypass graft (CABG), and percutaneous coronary intervention (PCI). With the development of drug-eluting stents, PCI is now widely used as the firstline treatment around the world. The advantage of CABG over PCI, however, remains in patients with left main coronary artery disease, three-vessel disease, and diffuse CAD. PCI and CABG do not exist in isolation because relieving the symptoms of angina is not the goal of treatment of CAD. Secondary prevention with vigorous modification of risk factors should be initiated and maintained. Among coronary risk factors, diabetes mellitus (DM) remains the most important one to predict poor early and late outcomes even in patients undergoing complete revascularization with CABG. Lowering the blood glucose level is important, but strict glycemic control is not necessarily associated with further reduction of cardiovascular events. Modification of insulin resistance with pioglitazone and metformin, lipid-lowering therapy with a statin, lowering blood pressure to <130/80 mmHg, and antiplatelet therapy should be considered in individuals with DM. A major concern is suboptimal modifications of risk factors in patients with DM and CABG in the real world. We should bear in mind this treatment gap and provide medical therapy for patients who need it most.

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Section: Indications For Cabgmentioning

confidence: 99%

“…32 Patients with DM often have diffuse coronary disease and are at high risk of coronary events, and they are often treated with PCI. In the BARI trial, 1829 patients with multivessel disease were randomized at 18 centers to PCI (mainly with POBA) or CABG.…”

Section: Indications For Cabgmentioning

confidence: 99%