Abstract
The primary objective of invasive treatment strategies for multivessel coronary artery disease is complete anatomical revascularization - traditionally considered the strongest predictor of improved clinical outcome in this setting. This concept, however, is being challenged by evidence suggesting that addressing ischemia is the key to reducing mortality, myocardial infarction, and life-limiting angina. As objective evidence of ischemia can be provided by a functional assessment on the basis of fractional flow reserve, the focus of contemporary treatment should arguably shift from anatomical to functional revascularization. Moreover, the decision to revascularize specific lesions should be made after consideration of the degree of myocardial viability, ischemic burden, overall clinical risk, and technical feasibility. Most importantly, however, the revascularization strategy should be tailored to the individual patient and the expertise of the institution, and use contemporary techniques combined with modern pharmacotherapy. This Perspectives article summarizes the data supporting contemporary functional revascularization and its applicability to real-world practice.
| Original language | English |
|---|---|
| Pages (from-to) | 243-252 |
| Number of pages | 10 |
| Journal | Nature Reviews Cardiology |
| Volume | 9 |
| Issue number | 4 |
| DOIs | |
| Publication status | Published - Apr 2012 |
Fingerprint
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
Cite this
Revascularization in multivessel CAD : A functional approach. / Shannon, Joanne; Colombo, Antonio.
In: Nature Reviews Cardiology, Vol. 9, No. 4, 04.2012, p. 243-252.Research output: Contribution to journal › Article
}
TY - JOUR
T1 - Revascularization in multivessel CAD
T2 - A functional approach
AU - Shannon, Joanne
AU - Colombo, Antonio
PY - 2012/4
Y1 - 2012/4
N2 - The primary objective of invasive treatment strategies for multivessel coronary artery disease is complete anatomical revascularization - traditionally considered the strongest predictor of improved clinical outcome in this setting. This concept, however, is being challenged by evidence suggesting that addressing ischemia is the key to reducing mortality, myocardial infarction, and life-limiting angina. As objective evidence of ischemia can be provided by a functional assessment on the basis of fractional flow reserve, the focus of contemporary treatment should arguably shift from anatomical to functional revascularization. Moreover, the decision to revascularize specific lesions should be made after consideration of the degree of myocardial viability, ischemic burden, overall clinical risk, and technical feasibility. Most importantly, however, the revascularization strategy should be tailored to the individual patient and the expertise of the institution, and use contemporary techniques combined with modern pharmacotherapy. This Perspectives article summarizes the data supporting contemporary functional revascularization and its applicability to real-world practice.
AB - The primary objective of invasive treatment strategies for multivessel coronary artery disease is complete anatomical revascularization - traditionally considered the strongest predictor of improved clinical outcome in this setting. This concept, however, is being challenged by evidence suggesting that addressing ischemia is the key to reducing mortality, myocardial infarction, and life-limiting angina. As objective evidence of ischemia can be provided by a functional assessment on the basis of fractional flow reserve, the focus of contemporary treatment should arguably shift from anatomical to functional revascularization. Moreover, the decision to revascularize specific lesions should be made after consideration of the degree of myocardial viability, ischemic burden, overall clinical risk, and technical feasibility. Most importantly, however, the revascularization strategy should be tailored to the individual patient and the expertise of the institution, and use contemporary techniques combined with modern pharmacotherapy. This Perspectives article summarizes the data supporting contemporary functional revascularization and its applicability to real-world practice.
UR - http://www.scopus.com/inward/record.url?scp=84859108135&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84859108135&partnerID=8YFLogxK
U2 - 10.1038/nrcardio.2011.213
DO - 10.1038/nrcardio.2011.213
M3 - Article
C2 - 22290233
AN - SCOPUS:84859108135
VL - 9
SP - 243
EP - 252
JO - Nature Reviews Cardiology
JF - Nature Reviews Cardiology
SN - 1759-5002
IS - 4
ER -