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ESC/EACTS statement on the 2022 Joint ESC/EACTS review of the 2018 guideline recommendations on the revascularization of left main coronary artery disease in patients at low surgical risk and anatomy suitable for PCI or CABG

Coronary Artery Disease, Acute Coronary Syndromes, Acute Cardiac Care


The European Society of Cardiology (ESC) and the European Association for Cardiothoracic Surgery (EACTS) have collaborated on reviewing the evidence for the treatment of low surgical-risk patients with left main coronary artery disease. The review, authored by a panel chaired by Professors Robert Byrne and Stephen Fremes, was published today in the European Heart Journal and the European Journal of Cardio-Thoracic Surgery.

The expert group’s conclusion, after a comprehensive review of all relevant evidence, is that for low-surgical risk patients, both coronary artery bypass surgery (CABG) and percutaneous coronary intervention (PCI) are clinically reasonable based on patient preference, available expertise, and local operator volumes. They have advised that in future guidelines the class of recommendation and level of evidence for CABG should be Class I and Level of Evidence A, whilst for PCI it should be Class IIa and Level of Evidence A. Their report and associated materials are now being considered by the Task Force working on a new guideline for Chronic Coronary Syndromes, scheduled for publication in August 2024. Until then, the ESC and EACTS believe that that local Heart Teams should consider both the current (2018) guidelines and the findings of the expert group when discussing the management of patients with stable coronary artery disease.  

 

Notes to editor

ESC Press Office
Tel: +33 (0) 6 61 40 18 84
Email: press@escardio.org

References

2022 Joint ESC/EACTS review of the 2018 guideline recommendations on the revascularization of left main coronary artery disease in patients at low surgical risk and anatomy suitable for PCI or CABG. European Heart Journal 2023. https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehad476

Editorial : Revascularization of low-surgical risk patients with disease of the left main coronary artery: a fresh look at the evidence. European Heart Journal 2023. https://academic.oup.com/eurheartj/article-lookup/doi/10.1093/eurheartj/ehad506

 

About the European Society of Cardiology

The ESC brings together health care professionals from more than 150 countries, working to advance cardiovascular medicine and help people to live longer, healthier lives.