Chronic stable angina revascularization guidelines for percutaneous coronary intervention
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Chronic stable angina Microchapters | ||
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Classification | ||
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Differentiating Chronic Stable Angina from Acute Coronary Syndromes | ||
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Diagnosis | ||
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Alternative Therapies for Refractory Angina | ||
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Discharge Care | ||
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Guidelines for Asymptomatic Patients | ||
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Case Studies | ||
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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-In-Chief: Lakshmi Gopalakrishnan, M.B.B.S.
ACC/AHA/ACP–ASIM Guidelines for the Management of Patients With Chronic Stable Angina (Do Not Edit)[1]
Revascularization With PTCA in Patients With Stable Angina (Do Not Edit)[1]
| Class I |
| "1. PTCA for patients with two- or three-vessel disease with significant proximal left anterior descending CAD, who have anatomy suitable for catheter-based therapy, normal LV function, and who do not have treated diabetes. (Level of Evidence: B)" |
| "2. PTCA or CABG for patients with one- or two-vessel CAD without significant proximal left anterior descending CAD but with a large area of viable myocardium and high-risk criteria on noninvasive testing. (Level of Evidence: B)" |
| "3. In patients with prior PTCA, CABG or PTCA for recurrent stenosis associated with a large area of viable myocardium and/or high-risk criteria on noninvasive testing. (Level of Evidence: C)" |
| "4. PTCA or CABG for patients who have not been successfully treated by medical therapy and can undergo revascularization with acceptable risk. (Level of Evidence: B)" |
| Class III |
| "1. PTCA or CABG for patients with one- or two-vessel CAD without significant left anterior descending CAD who have mild symptoms that are unlikely due to myocardial ischemia or have not received an adequate trial of medical therapy and |
| a. have only a small area of viable myocardium, or |
| b. have no demonstrable ischemia on noninvasive testing. (Level of Evidence: C)" |
| "2. PTCA or CABG for patients with borderline coronary stenoses (50% to 60% diameter in locations other than the left main) and no demonstrable ischemia on noninvasive testing. (Level of Evidence: C)" |
| "3. PTCA or CABG for patients with insignificant coronary stenoses (less than 50% diameter). (Level of Evidence: C)" |
| "4. PTCA in patients with significant left main CAD who are candidates for CABG. (Level of Evidence: B)" |
| Class IIa |
| "1. Repeat CABG for patients with multiple saphenous vein graft stenoses, especially when there is significant stenosis of a graft supplying the left anterior descending coronary artery. PTCA may be appropriate for focal saphenous vein graft lesions or multiple stenoses in poor candidates for reoperative surgery. (Level of Evidence: C)" |
| "2. PTCA or CABG for patients with one- or two-vessel CAD without significant proximal left anterior descending CAD but with a moderate area of viable myocardium and demonstrable ischemia on noninvasive testing. (Level of Evidence: B)" |
| "3. PTCA or CABG for patients with one-vessel disease with significant proximal left anterior descending CAD. (Level of Evidence: B)" |
| Class IIb |
| "1. Compared with CABG, PTCA for patients with two- or three-vessel disease with significant proximal left anterior descending CAD who have anatomy suitable for catheter-based therapy and who have treated diabetes or abnormal LV function. (Level of Evidence: B)" |
| "2. PTCA for patients with significant left main coronary disease who are not candidates for CABG. (Level of Evidence: C)" |
| "3. PTCA for patients with one- or two-vessel CAD without significant proximal left anterior descending CAD who have survived sudden cardiac death or sustained ventricular tachycardia. (Level of Evidence: C)" |
ESC Guidelines- Revascularization to improve prognosis[2] (DO NOT EDIT)
| Class IIa |
| "1. PCI or CABG for patients with reversible ischaemia on functional testing and evidence of frequent episodes of ischaemia during daily activities. (Level of Evidence: C)" |
ESC Guidelines- Revascularization to improve symptoms (DO NOT EDIT) [2]
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Class I
1. PCI for one-vessel disease technically suitable for percutaneous revascularization in patients with moderate-to-severe symptoms not controlled by medical therapy, in whom procedural risks do not outweigh potential benefits. (Level of Evidence: A)
2. PCI for multi-vessel disease without high-risk coronary anatomy, technically suitable for percutaneous revascularization in patients with moderate-to-severe symptoms not controlled by medical therapy, in whom procedural risks do not outweigh potential benefits. (Level of Evidence: A)
| Class IIa |
| "1. PCI for one-vessel disease technically suitable for
percutaneous revascularization in patients with mild-to-moderate symptoms which are nonetheless unacceptable to the patient, in whom procedural risks do not outweigh potential benefits. (Level of Evidence: A)" |
| "2. PCI for multi-vessel disease technically suitable for percutaneous revascularization in patients with mild-to-moderate symptoms which are nonetheless unacceptable to the patient, in whom procedural risks do not outweigh potential benefits. (Level of Evidence: A)" |
References
- ↑ 1.0 1.1 Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM; et al. (1999). "ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: executive summary and recommendations. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients with Chronic Stable Angina)". Circulation. 99 (21): 2829–48. PMID 10351980.
- ↑ 2.0 2.1 Fox K, Garcia MA, Ardissino D, Buszman P, Camici PG, Crea F; et al. (2006). "Guidelines on the management of stable angina pectoris: executive summary: The Task Force on the Management of Stable Angina Pectoris of the European Society of Cardiology". Eur Heart J. 27 (11): 1341–81. doi:10.1093/eurheartj/ehl001. PMID 16735367.