Nuffield Department of Surgery, University of Oxford, John Radcliffe Hospital, Oxford, UK.
Ann Cardiothorac Surg. 2013 Jul;2(4):431-4. doi: 10.3978/j.issn.2225-319X.2013.07.20.
In addition to optimal medical therapy, some patients with coronary artery disease also require intervention on symptomatic and/or prognostic grounds. The debate over the relative efficacies of coronary artery bypass grafting (CABG) and stenting has recently been settled by the publication of the five-year outcomes of the SYNTAX and FREEDOM (in patients with diabetes) trials accompanied by supportive data from several large registries. There is also current evidence that stenting is still carried out in patients who would be better served by CABG, emphasizing the need for recommendations for intervention to be overseen by a multidisciplinary team rather than the individual practitioner.
除了最佳的医学治疗外,一些患有冠状动脉疾病的患者还需要根据症状和/或预后进行干预。最近,SYNTAX 和 FREEDOM(糖尿病患者)试验的五年结果的公布解决了冠状动脉旁路移植术(CABG)和支架置入术的相对疗效的争议,并伴有来自几个大型注册中心的支持数据。目前还有证据表明,即使在 CABG 治疗效果更好的患者中,仍在进行支架置入术,这强调了干预建议应由多学科团队而不是个别医生监督。