Table of contents
1. Preamble
2. Introduction
2.1 What is new in the 2018 Guidelines?
3.Diagnostic tools to guide myocardial revascularization
3.1 Non-invasive diagnostic tools
3.2 Invasive diagnostic tools
3.3 Gaps in the evidence
4. Process for decision-making and patient information
4.1 Patient information and informed consent
4.2 Multidisciplinary decision-making (Heart Team)
4.3 Timing of revascularization
5. Revascularization for stable coronary artery disease
5.1 Rationale for revascularization
5.2 Evidence basis for revascularization
5.3 Percutaneous coronary intervention vs. coronary artery bypass grafting
5.4 Gaps in the evidence
6. Revascularization in non-ST-elevation acute coronary syndrome
6.1 Early invasive vs. conservative strategy
6.2 Timing of angiography and intervention
6.3 Type of revascularization
6.4 Gaps in the evidence
7. Revascularization in ST-segment elevation myocardial infarction
7.1 Time delays
7.2 Selection of reperfusion strategy
7.3 Primary percutaneous coronary intervention
7.4 Percutaneous coronary intervention after thrombolysis and in patients with late diagnosis
7.5 Gaps in the evidence
8. Myocardial revascularization in patients with heart failure
8.1Chronic heart failure
8.2 Acute heart failure and cardiogenic shock
8.3 Gaps in the evidence
9. Revascularization in patients with diabetes
9.1 Evidence for myocardial revascularization
9.2 Type of myocardial revascularization
9.3 Revascularization with the use of percutaneous coronary intervention
9.4 Antithrombotic pharmacotherapy
9.5 Metformin
9.6 Gaps in the evidence
10. Revascularization in patients with chronic kidney disease
10.1 Evidence base for revascularization and recommendations
10.2 Prevention of contrast-induced nephropathy
10.3 Gaps in the evidence
11. Revascularization in patients requiring valve interventions
11.1 Primary indication for valve interventions
11.2 Primary indication for myocardial revascularization
11.3 Gaps in the evidence
12 .Associated peripheral artery diseases
12.1 Prevention of stroke associated with carotid artery disease and myocardial revascularization
12.2 Associated coronary and peripheral artery diseases
13. Repeat revascularization and hybrid procedures
13.1 Early graft failure
13.2 Acute percutaneous coronary intervention failure
13.3 Disease progression and late graft failure
13.4 Repeat percutaneous coronary intervention
14. Arrhythmias
14.1 Ventricular arrhythmias
14.2 Atrial arrhythmias
14.3 Gaps in the evidence
15. Procedural aspects of coronary artery bypass grafting
15.1 Surgical techniques
15.2 Reporting perioperative outcomes
15.3 Gaps in the evidence
16. Procedural aspects of percutaneous coronary intervention
16.1 Percutaneous coronary intervention devices
16.2 Invasive imaging tools for procedural guidance
16.3 Specific lesion subsets
16.4 Vascular access
17. Antithrombotic treatments
17.1 Percutaneous coronary intervention in stable coronary artery disease
17.2 Non-ST-segment elevation acute coronary syndrome
17.3 ST-segment elevation myocardial infarction
17.4 Coronary artery bypass grafting
17.5 Special conditions
17.6 Gaps in the evidence
18 .Volume–outcome relationship for revascularization procedures
18.1 Coronary artery bypass grafting
18.2 Percutaneous coronary intervention
18.3 Training in cardiac surgery and interventional cardiology for myocardial revascularization
19. Medical therapy, secondary prevention, and strategies for follow-up
19.1 Gaps in the evidence
20. Key messages
21. Evidence-based “to do” and “not to do” messages from the Guidelines
Appendix
References