New ACC/AHA guidelines detail updated recommendations for PCI, CABG

The American College of Cardiology (ACC) and American Heart Association (AHA), through a collaboration with the Society for Cardiovascular Angiography and Interventions, have published a new guidance focused on coronary artery revascularization procedures.

The document represents an update of previous guidelines on percutaneous coronary intervention (PCI) and coronary artery bypass graft (CABG) from 2011 and 2015, respectively.  

“Coronary artery disease remains a leading cause of morbidity and mortality globally, and coronary revascularization is an important therapeutic option when managing patients with this disease,” Jennifer S. Lawton, MD, guideline writing committee chair, said in a prepared statement. “Treatment recommendations in the guideline outline an evidence-based approach to managing patients with coronary artery disease who are being considered for coronary revascularization, with the intent to improve quality of care and align with patients’ interests.”

One of the writing committee’s primary goals was to reduce disparities of care. Men and women—as well as patients of various races and ethnicities—have comparable responses to coronary revascularization, the group noted, so the use of these procedures should be equal among all patient populations. Prior studies have suggested that non-white patients are less likely to undergo PCI or CABG, for example, and the writing group hopes its updated guidance can limit such trends going forward.

Another key point of the new guidance is to highlight the significance of multidisciplinary heart teams when it comes to making treatment decisions.

“The heart team has become an important paradigm in clinical practice, emphasizing the importance of team consensus on the optimal approach to revascularization,” Jacqueline E. Tamis-Holland, MD, vice-chair of the guideline writing committee, said in the same statement.

Recommendations related to a wide range of other topics have also been updated. Dual antiplatelet therapy (DAPT) that lasts one to three months after PCI, for instance, is now viewed as a safer option for many patients than DAPT that lasts six to 12 months.

The full guidelines have been published in both the Journal of the American College of Cardiology and Circulation. Additional information from the ACC is also available here and here.  

Michael Walter
Michael Walter, Managing Editor

Michael has more than 18 years of experience as a professional writer and editor. He has written at length about cardiology, radiology, artificial intelligence and other key healthcare topics.

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