Department of Cardiothoracic Surgery, Jena University Hospital, Friedrich-Schiller-University of Jena, Jena, Germany.
Department of Medicine, Northwestern University Feinberg School of Medicine, Chicago, Illinois, USA.
J Am Coll Cardiol. 2021 Jul 13;78(2):180-188. doi: 10.1016/j.jacc.2021.05.010.
Coronary artery disease (CAD) is treated with medical therapy with or without percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The latter 2 options are commonly referred to as "myocardial revascularization" procedures. We reason that this term is inappropriate because it is suggestive of a single treatment effect of PCI and CABG (ie, the reestablishment of blood flow to ischemic myocardium) and obscures key mechanisms, such as the improvement in coronary flow capability in the absence of ongoing ischemia, the reperfusion in the presence of ischemia, and the prevention of myocardial infarction from CAD progression. We review the current evidence on the topic and suggest the use of a purely descriptive terminology ("invasive treatment by PCI or CABG") which has the potential to improve clinical decision making and guide future trial design.
冠状动脉疾病(CAD)的治疗方法包括药物治疗,以及经皮冠状动脉介入治疗(PCI)或冠状动脉旁路移植术(CABG)。后两种方法通常被称为“血运重建”手术。我们认为这个术语不合适,因为它暗示了 PCI 和 CABG 的单一治疗效果(即,重新建立缺血心肌的血流),并掩盖了关键机制,如在没有持续缺血的情况下改善冠状动脉血流能力、在存在缺血的情况下再灌注以及预防 CAD 进展导致的心肌梗死。我们回顾了该主题的现有证据,并建议使用纯粹描述性的术语(“通过 PCI 或 CABG 的侵入性治疗”),这有可能改善临床决策并指导未来的试验设计。
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