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European Society of Cardiology guidelines for Myocardial Revascularisation

Embargoed for release: Sunday, 29 August 2010 at 1000hrs

Myocardial Disease

Stockholm, Sweden; 29 August 2010: The European Society of Cardiology (ESC) today announces the release of new Clinical Practice Guidelines covering Myocardial Revascularisation. These guidelines were developed following pioneering and extensive co-operation between the ESC and the European Association of Cardio-Thoracic Surgeons (EACTS). Myocardial Revascularisation – simply, the restoration of adequate blood and oxygen supplies to the heart – is the collective term for the response to the symptoms of coronary artery disease (CAD), including heart attacks and angina. The new guidelines will be presented at the ESC Congress in Stockholm on 29 August during the Clinical Practice Guidelines session in lecture room Stockholm, Zone K, starting at 0845hrs.

These guidelines reflect the fact that there are many options available to physicians to treat the many forms of CAD, both acute and non-acute.  These include surgery, stent implantation and drug therapies, and the options cross traditional boundaries of medicine such as cardiology and surgery.   “Our intention in writing these guidelines was to give patient-centred recommendations that lead to the most appropriate treatment regime for the different types of CAD,” said Doctor William Wijns of the ESC and Co-Chair of the Task Force.  “We also wanted to provide reference materials based on best practice but not conditioned by the skill and preferences of individual physicians. The major challenge faced by physicians is not how to treat the CAD patient, but which of the many treatment options to select.”

The Task Force was made up of 24 experts, drawn equally from surgeons, interventional cardiologists and general cardiologists, and representing the ESC and the EACTS.  The new guidelines are noteworthy for three main reasons:

  • They are an example of strong co-operation between the ESC and the EACTS, and have proved to very successful in meeting the objectives.
  • The content addresses the full extent of CAD, and of associated diseases, which was previously covered in separate guidelines, or not at all.
  • The guidelines introduce the concept of Heart Teams, essentially a grouping from across disciplines ensuring – when practical – that the patient is fully informed and takes part in the key decisions. The heart team should include one of each of the following specialists; interventional cardiologist, clinical cardiologist, and cardiac surgeon.

The guidelines encompass the full extent of CAD treatment and expected outcomes, including managing stable and unstable angina, myocardial infarction, diabetes-related symptoms and associated renal failure.  Recommendations are made on all treatment options, from the technical aspects of stent implantation to the use of imaging technologies, and from risk management to follow-up activities.

The establishment of Heart Teams is a vital recommendation for medical teams everywhere, and formalises the make-up of the multi-discipline team responsible for patient care following CAD treatment.  Co-Chair, Professor Philippe Kolh of the EACTS explains, “It is important that physicians offer patients the opportunity to influence the response to their condition.  Clearly, for acute cases, such flexibility can be difficult to accommodate, but for the 30 percent of patients with stable conditions, it is an important factor. Immediate but less durable treatments such as a stent implantation may not be the right choice for some patients.  Depending on their lifestyle and responsibilities, some may prefer to elect for a surgical procedure that offers a longer-term result.”

Practitioners that will be using the new guidelines, as well as journalists, are offered the opportunity to have an open discussion and Q&A with Doctor Wijns and Professor Kolh and members of the Task Force.  A ‘Meet the Guidelines Task Force’ session takes place on Tuesday 31 August in lecture room Moscow, Zone A starting at 1005hrs. 

The complete guidelines document can be downloaded from the ESC website at



This press release accompanies both a presentation and an ESC press conference given at the ESC Congress 2010. The press release has been written and/or edited by the ESC from information provided by the investigator and does not necessarily reflect the opinion of the European Society of Cardiology. The content of the press release has been approved by the investigator.

Notes to editor

About guidelines
ESC Clinical Practice Guidelines are scientifically recognised worldwide as providing practicing physicians with the best possible recommendations on diagnosis, treatment and management of specific topics in cardiology medicine. Guidelines are created and edited under the umbrella of the ESC Board and the Committee for Practice Guidelines (CPG), who form a Task Force of appropriate experts from the ESC Associations, Working Groups, Councils, and National Societies, and from other bodies when required. They are the result of consensus amongst the Task Force appointed to prepare them, and they are peer-reviewed in a thorough and rigorous process that ensures accuracy, best-practice and relevance. Guidelines are available in a variety of printed and electronic media and in multiple formats including full documents, pocket guides and summaries.

About the European Society of Cardiology
The European Society of Cardiology (ESC) represents more than 62,000 cardiology professionals across Europe and the Mediterranean. Its mission is to reduce the burden of cardiovascular disease in Europe.
About ESC Congress 2010
ESC Congress 2010 will take place from 28 August to 1 September at the Stockholmsmässan, Stockholm. Information on the scientific programme is available at More information on ESC Congress 2010 is available from the ESC's press office at