Coronary artery bypass grafting recommendations have been relatively downgraded in certain patient subsets in contemporary clinical guidelines following recent pivotal trials.
This review highlights the evolving role of CABG in contemporary practice, reflecting recent guideline updates and pivotal clinical trials that emphasize a more selective approach to revascularization.
Coronary artery disease (CAD) remains a leading cause of morbidity and mortality worldwide, necessitating evidence-based treatment strategies to optimize patient outcomes 1,2) .Clinical guidelines established by major cardiovascular societies, including the European Society of Cardiology (ESC), the European Association for Cardiothoracic Surgery (EACTS), the American College of Cardiology (ACC), the American Heart Association (AHA), and the Japanese Circulation Society (JCS), provide structured recommendations for the management of CAD 123 .These guidelines primarily focus on the selection of coronary revascularization strategies, particularly coronary artery bypass grafting (CABG) and percutaneous coronary intervention (PCI), in conjunction with optimal medical therapy (OMT).Despite the shared goal of improving cardiovascular outcomes, significant differences exist among these guidelines in their recommendations regarding revascularization, risk stratification, and the role of the multidisciplinary heart team in decision-making.In recent years, pivotal clinical trials, such as the ISCHEMIA and FREEDOM trials, have influenced guideline revisions, shifting emphasis toward a more selective approach to revascularization 456 .Consequently, CABG, once widely recommended for multivessel disease, has seen a relative downgrading in certain patient subsets, leading to ongoing debate regarding its optimal role in contemporary practice.This review examines the evolving landscape of CABG in current clinical guidelines, critically analyzing recent updates, and the impact of major trials on treatment recommendations.In addition, advancements in surgical techniques, including arterial graft selection, off-pump CABG, minimally invasive approaches,
Oishi et al. (Tue,) conducted a review in Coronary artery disease. Coronary artery bypass grafting (CABG) vs. Percutaneous coronary intervention (PCI) and optimal medical therapy was evaluated. Coronary artery bypass grafting recommendations have been relatively downgraded in certain patient subsets in contemporary clinical guidelines following recent pivotal trials.