Clinical Practice Guideline: Full Text
2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

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Abstract

Aim

The guideline for coronary artery revascularization replaces the 2011 coronary artery bypass graft surgery and the 2011 and 2015 percutaneous coronary intervention guidelines, providing a patient-centric approach to guide clinicians in the treatment of patients with significant coronary artery disease undergoing coronary revascularization as well as the supporting documentation to encourage their use.

Methods

A comprehensive literature search was conducted from May 2019 to September 2019, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, CINHL Complete, and other relevant databases. Additional relevant studies, published through May 2021, were also considered.

Structure

Coronary artery disease remains a leading cause of morbidity and mortality globally. Coronary revascularization is an important therapeutic option when managing patients with coronary artery disease. The 2021 coronary artery revascularization guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present 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.

Key Words

ACC/AHA Clinical Practice Guidelines
percutaneous coronary intervention
angioplasty
coronary artery bypass graft surgery
myocardial infarction
cardiac surgery
stent(s)
angiogram
angiography
percutaneous transluminal coronary angioplasty
coronary atherosclerosis
saphenous vein graft
internal mammary artery graft
internal thoracic artery graft
arterial graft
post-bypass
non–ST-segment–elevated myocardial infarction
vein graft lesions
myocardial revascularization
multivessel PCI
left ventricular dysfunction

Cited by (0)

This document was approved by the American College of Cardiology Clinical Policy Approval Committee, the American Heart Association Science Advisory and Coordinating Committee, the American College of Cardiology Science and Quality Committee, the American Heart Association Executive Committee, and the Society for Cardiovascular Angiography and Interventions Executive Committee in August 2021.

The American College of Cardiology requests that this document be cited as follows: Lawton JS, Tamis-Holland JE, Bangalore S, Bates ER, Beckie TM, Bischoff JM, Bittl JA, Cohen MG, DiMaio JM, Don CW, Fremes SE, Gaudino MF, Goldberger ZD, Grant MC, Jaswal JB, Kurlansky PA, Mehran R, Metkus TS Jr, Nnacheta LC, Rao SV, Sellke FW, Sharma G, Yong CM, Zwischenberger BA. 2021 ACC/AHA/SCAI guideline for coronary artery revascularization: a report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines. J Am Coll Cardiol. 2022;79:e21-e129.

This article has been copublished in Circulation.

Copies: This document is available on the websites of the American College of Cardiology (www.acc.org) and the American Heart Association (professional.heart.org). For copies of this document, please contact the Elsevier Inc. Reprint Department via fax (212-633-3820) or e-mail ([email protected]).

Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American College of Cardiology. Requests may be completed online via the Elsevier website (https://www.elsevier.com/about/policies/copyright/permissions).

Writing committee members are required to recuse themselves from voting on sections to which their specific relationships with industry may apply; see Appendix 1 for detailed information.

ACC/AHA Representative.

ACC/AHA Joint Committee on Clinical Practice Guidelines Liaison.

§

ACC/AHA Task Force on Data Standards Representative.

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SCAI Representative.

Former Joint Committee member; current member during the writing effort.