Does coronary artery revascularisation (surgical or percutaneous) improve outcomes compared to medical therapy in patients with obstructive coronary artery disease?
This review summarizes current concepts in coronary revascularization, highlighting the trade-offs between surgical and percutaneous approaches and emphasizing the urgent need for data in more diverse patient populations.
Coronary artery revascularisation can be performed surgically or percutaneously. Surgery is associated with higher procedural risk and longer recovery than percutaneous interventions, but with long-term reduction of recurrent cardiac events. For many patients with obstructive coronary artery disease in need of revascularisation, surgical or percutaneous intervention is indicated on the basis of clinical and anatomical reasons or personal preferences. Medical therapy is a crucial accompaniment to coronary revascularisation, and data suggest that, in some subsets of patients, medical therapy alone might achieve similar results to coronary revascularisation. Most revascularisation data are based on prevalently White, non-elderly, male populations in high-income countries; robust data in women, older adults, and racial and other minorities, and from low-income and middle-income countries, are urgently needed.
Gaudino et al. (Thu,) studied this question.