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Cited by 528Coronary Interventions and DiagnosticsCardiac and Coronary Surgery TechniquesCardiac Imaging and Diagnostics

PCI and CABG for Treating Stable Coronary Artery Disease

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Doenst, Torsten, Haverich, Axel, Serruys, Patrick, Bonow, Robert O., Kappetein, Pieter, Falk, Volkmar, Velazquez, Eric, Diegeler, Anno +1 more·2019·Journal of the American College of Cardiology
DOI 10.1016/j.jacc.2018.11.053
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Abstract

Percutaneous coronary intervention (PCI) and coronary artery bypass grafting (CABG) are considered revascularization procedures, but only CABG can prolong life in stable coronary artery disease. Thus, PCI and CABG mechanisms may differ. Viability and/or ischemia detection to guide revascularization have been unable to accurately predict treatment effects of CABG or PCI, questioning a revascularization mechanism for improving survival. By contrast, preventing myocardial infarction may save lives. However, the majority of infarcts are generated by non-flow-limiting stenoses, but PCI is solely focused on treating flow-limiting lesions. Thus, PCI cannot be expected to significantly limit new infarcts, but CABG may do so through providing flow distal to vessel occlusions. All comparisons of CABG to PCI or medical therapy that demonstrate survival effects with CABG also demonstrate infarct reduction. Thus, CABG may differ from PCI by providing "surgical collateralization," prolonging life by preventing myocardial infarctions. The evidence is reviewed here.

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Authors
Doenst, T., Haverich, A., Serruys, P., Bonow, R. O., Kappetein, P., Falk, V., Velazquez, E., Diegeler, A., & Sigusch, H.
Affiliations
  • Jena University Hospital (DE)
  • Medizinische Hochschule Hannover (DE)
  • Imperial College London (GB)
  • Northwestern University (US)
  • Deutsches Herzzentrum der Charité (DE)
  • Yale University (US)
Corresponding author
Doenst, Torsten
ORCID
Venue
Journal of the American College of Cardiology
Publisher
Elsevier BV
Published
2019-03
Volume
73
Issue
8
Pages
964-976
ISSN
0735-1097 (ISSN-L)
DOI
10.1016/j.jacc.2018.11.053
OpenAlex
W2917773996
Cited by
528
References
73
Citations by year
2026: 67 · 2025: 103 · 2024: 88 · 2023: 73 · 2022: 76 · 2021: 52 · 2020: 47 · 2019: 22
FWCI
10.15
Type
journal article
Language
en
Open access
Licence
Locations
  • Journal of the American College of Cardiology (publishedVersion)
  • PubMed (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (publishedVersion)
  • EUR Research Repository (Erasmus University Rotterdam) (submittedVersion)
Topics
  • Health Sciences › Medicine › Surgery › Coronary Interventions and Diagnostics
  • Health Sciences › Medicine › Surgery › Cardiac and Coronary Surgery Techniques
  • Health Sciences › Medicine › Radiology, Nuclear Medicine and Imaging › Cardiac Imaging and Diagnostics
Keywords
percutaneous coronary intervention, coronary artery bypass grafting, stable coronary artery disease, coronary revascularization, myocardial infarction prevention, myocardial viability, survival outcomes
MeSH terms
Coronary Artery Bypass, Coronary Artery Disease, Humans, Treatment Outcome, Coronary Angiography, Percutaneous Coronary Intervention

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