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改善描述冠状动脉程序的术语:JACC 每周综述专题。

Improving Terminology to Describe Coronary Artery Procedures: JACC Review Topic of the Week.

机构信息

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.

出版信息

J Am Coll Cardiol. 2021 Jul 13;78(2):180-188. doi: 10.1016/j.jacc.2021.05.010.


DOI:10.1016/j.jacc.2021.05.010
PMID:34238439
Abstract

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.

摘要

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。

相似文献

[1]
Improving Terminology to Describe Coronary Artery Procedures: JACC Review Topic of the Week.

J Am Coll Cardiol. 2021-7-13

[2]
Coronary artery bypass graft surgery vs percutaneous interventions in coronary revascularization: a systematic review.

JAMA. 2013-11-20

[3]
PCI and CABG for Treating Stable Coronary Artery Disease: JACC Review Topic of the Week.

J Am Coll Cardiol. 2019-3-5

[4]
Balancing benefit against risk in the choice of therapy for coronary artery disease. Lesson from prospective, randomized, clinical trials of percutaneous coronary intervention and coronary artery bypass graft surgery.

Minerva Cardioangiol. 2003-10

[5]
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Circ Cardiovasc Interv. 2019-9-9

[6]
Percutaneous coronary intervention vs. cardiac surgery in diabetic patients. Where are we now and where should we be going?

Hellenic J Cardiol. 2017-2-16

[7]
Coronary Artery Bypass Surgery Versus Drug-Eluting Stent Implantation for Left Main or Multivessel Coronary Artery Disease: A Meta-Analysis of Individual Patient Data.

JACC Cardiovasc Interv. 2016-12-26

[8]
Bypass Surgery or Stenting for Left Main Coronary Artery Disease in Patients With Diabetes.

J Am Coll Cardiol. 2019-4-9

[9]
Stroke Rates Following Surgical Versus Percutaneous Coronary Revascularization.

J Am Coll Cardiol. 2018-7-24

[10]
Clinical outcomes with percutaneous coronary revascularization vs coronary artery bypass grafting surgery in patients with unprotected left main coronary artery disease: A meta-analysis of 6 randomized trials and 4,686 patients.

Am Heart J. 2017-8

引用本文的文献

[1]
The Role of Myocardial Revascularization in Ischemic Heart Failure in the Era of Modern Optimal Medical Therapy.

Medicina (Kaunas). 2025-8-12

[2]
Coronary CT angiography evaluation with artificial intelligence for individualized medical treatment of atherosclerosis: a Consensus Statement from the QCI Study Group.

Nat Rev Cardiol. 2025-8-1

[3]
The Gut Microbiota Mediates the Protective Effects of Spironolactone on Myocardial Infarction.

J Microbiol. 2024-10

[4]
Invasive Treatment of Left Main Coronary Artery Disease: From Anatomical Features to Mechanistic Differences.

Curr Cardiol Rev. 2024

[5]
Comparing outcomes between coronary artery bypass grafting and percutaneous coronary intervention in octogenarians with left main or multivessel disease.

Sci Rep. 2023-12-15

[6]
Myocardial Revascularization in Patients With Ischemic Cardiomyopathy: For Whom and How.

J Am Heart Assoc. 2023-3-21

[7]
Comparing CABG and PCI across the globe based on current regional registry evidence.

Sci Rep. 2022-12-22

[8]
Percutaneous Coronary Intervention for Left Main Coronary Artery Disease: Present Status and Future Perspectives.

JACC Asia. 2022-3-15

[9]
The Treatment of Coronary Artery Disease.

Dtsch Arztebl Int. 2022-10-21

[10]
A systematic review and meta-analysis of percutaneous coronary intervention compared to coronary artery bypass grafting in non-ST-elevation acute coronary syndrome.

Sci Rep. 2022-3-24

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