Standardizing the Definition and Analysis Methodology for Complete Coronary Artery Revascularization
Ziad A. Ali, Jennifer van der Horst, Prakriti Gaba, Leslee J. Shaw, Sripal Bangalore, Judith S. Hochman, David J. Maron, Jeffrey W. Moses, María A. Alfonso, Mahesh V. Madhavan, Ovidiu Dressler, Harmony R. Reynolds, Gregg W. Stone
Abstract
Guideline-based medical therapy is the foundation of treatment for individuals with coronary artery disease. However, revascularization with either percutaneous coronary intervention or coronary artery bypass grafting may be beneficial in patients with acute coronary syndromes, refractory symptoms, or in other specific scenarios (eg, left main disease and heart failure). While the goal of percutaneous coronary intervention and coronary artery bypass grafting is to achieve complete revascularization, anatomical and ischemic definitions of complete revascularization and their methodology for assessment remain highly variable. Such lack of consensus invariably contributes to the absence of standardized approaches for invasive treatment of coronary artery disease. Herein, we propose a novel, comprehensive, yet pragmatic algorithm with both anatomical and ischemic parameters that aims to provide a systematic method to assess complete revascularization after percutaneous coronary intervention or coronary artery bypass grafting in both clinical practice and clinical trials.