A narrative review of revascularization in chronic coronary syndrome/disease: concepts and misconceptions

Detalhes bibliográficos
Autor(a) principal: Nogueira-Garcia, Beatriz
Data de Publicação: 2024
Outros Autores: Vilela, Marta, Oliveira, Catarina, Caldeira, Daniel, Martins, Ana Margarida, Menezes, Miguel Nobre
Tipo de documento: Artigo
Idioma: eng
Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
Texto Completo: http://hdl.handle.net/10451/65058
Resumo: Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).
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spelling A narrative review of revascularization in chronic coronary syndrome/disease: concepts and misconceptionsChronic coronary artery diseaseChronic coronary artery syndromeCoronary artery bypass surgeryPercutaneous coronary interventionPersonalized medicineCopyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).Ischemic heart disease represents a significant global burden of morbidity and mortality. While revascularization strategies are well defined in acute settings, there are uncertainties regarding chronic coronary artery disease treatment. Recent trials have raised doubts about the necessity of revascularization for "stable", chronic coronary syndromes or disease, leading to a shift towards a more conservative approach. However, the issue remains far from settled. In this narrative review, we offer a summary of the most pertinent evidence regarding revascularization for chronic coronary disease, while reflecting on less-often-discussed details of major clinical trials. The cumulative evidence available indicates that there can be a prognostic benefit from revascularization in chronic coronary syndrome patients, provided there is significant ischemia, as demonstrated by either imaging or coronary physiology. Trials that have effectively met this criterion consistently demonstrate a reduction in rates of spontaneous myocardial infarction, which holds both prognostic and clinical significance. The prognostic benefit of revascularization in patients with heart failure with reduced ejection fraction remains especially problematic, with a single contemporary trial favouring surgical revascularization. The very recent publication of a trial focused on revascularizing non-flow-limiting "vulnerable" plaques adds further complexity to the field. The ongoing debates surrounding revascularization in chronic coronary syndromes emphasize the importance of personalized strategies. Revascularization, added to the foundational pillar of medical therapy, should be considered, taking into account symptoms, patient preferences, coronary anatomy and physiology, ischemia tests and intra-coronary imaging.MDPIRepositório da Universidade de LisboaNogueira-Garcia, BeatrizVilela, MartaOliveira, CatarinaCaldeira, DanielMartins, Ana MargaridaMenezes, Miguel Nobre2024-06-18T13:34:27Z20242024-01-01T00:00:00Zinfo:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/articleapplication/pdfhttp://hdl.handle.net/10451/65058engJ Pers Med. 2024 May 10;14(5):50610.3390/jpm140505062075-4426info:eu-repo/semantics/openAccessreponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãoinstacron:RCAAP2024-11-20T18:30:42Zoai:repositorio.ul.pt:10451/65058Portal AgregadorONGhttps://www.rcaap.pt/oai/openairemluisa.alvim@gmail.comopendoar:71602024-11-20T18:30:42Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informaçãofalse
dc.title.none.fl_str_mv A narrative review of revascularization in chronic coronary syndrome/disease: concepts and misconceptions
title A narrative review of revascularization in chronic coronary syndrome/disease: concepts and misconceptions
spellingShingle A narrative review of revascularization in chronic coronary syndrome/disease: concepts and misconceptions
Nogueira-Garcia, Beatriz
Chronic coronary artery disease
Chronic coronary artery syndrome
Coronary artery bypass surgery
Percutaneous coronary intervention
Personalized medicine
title_short A narrative review of revascularization in chronic coronary syndrome/disease: concepts and misconceptions
title_full A narrative review of revascularization in chronic coronary syndrome/disease: concepts and misconceptions
title_fullStr A narrative review of revascularization in chronic coronary syndrome/disease: concepts and misconceptions
title_full_unstemmed A narrative review of revascularization in chronic coronary syndrome/disease: concepts and misconceptions
title_sort A narrative review of revascularization in chronic coronary syndrome/disease: concepts and misconceptions
author Nogueira-Garcia, Beatriz
author_facet Nogueira-Garcia, Beatriz
Vilela, Marta
Oliveira, Catarina
Caldeira, Daniel
Martins, Ana Margarida
Menezes, Miguel Nobre
author_role author
author2 Vilela, Marta
Oliveira, Catarina
Caldeira, Daniel
Martins, Ana Margarida
Menezes, Miguel Nobre
author2_role author
author
author
author
author
dc.contributor.none.fl_str_mv Repositório da Universidade de Lisboa
dc.contributor.author.fl_str_mv Nogueira-Garcia, Beatriz
Vilela, Marta
Oliveira, Catarina
Caldeira, Daniel
Martins, Ana Margarida
Menezes, Miguel Nobre
dc.subject.por.fl_str_mv Chronic coronary artery disease
Chronic coronary artery syndrome
Coronary artery bypass surgery
Percutaneous coronary intervention
Personalized medicine
topic Chronic coronary artery disease
Chronic coronary artery syndrome
Coronary artery bypass surgery
Percutaneous coronary intervention
Personalized medicine
description Copyright: © 2024 by the authors. Licensee MDPI, Basel, Switzerland. This article is an open access article distributed under the terms and conditions of the Creative Commons Attribution (CC BY) license (https:// creativecommons.org/licenses/by/ 4.0/).
publishDate 2024
dc.date.none.fl_str_mv 2024-06-18T13:34:27Z
2024
2024-01-01T00:00:00Z
dc.type.status.fl_str_mv info:eu-repo/semantics/publishedVersion
dc.type.driver.fl_str_mv info:eu-repo/semantics/article
format article
status_str publishedVersion
dc.identifier.uri.fl_str_mv http://hdl.handle.net/10451/65058
url http://hdl.handle.net/10451/65058
dc.language.iso.fl_str_mv eng
language eng
dc.relation.none.fl_str_mv J Pers Med. 2024 May 10;14(5):506
10.3390/jpm14050506
2075-4426
dc.rights.driver.fl_str_mv info:eu-repo/semantics/openAccess
eu_rights_str_mv openAccess
dc.format.none.fl_str_mv application/pdf
dc.publisher.none.fl_str_mv MDPI
publisher.none.fl_str_mv MDPI
dc.source.none.fl_str_mv reponame:Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
instname:Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron:RCAAP
instname_str Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
instacron_str RCAAP
institution RCAAP
reponame_str Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
collection Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
repository.name.fl_str_mv Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos) - Agência para a Sociedade do Conhecimento (UMIC) - FCT - Sociedade da Informação
repository.mail.fl_str_mv mluisa.alvim@gmail.com
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