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Coronary Revascularization Use Guidelines Released

Decision-making about individual patients should be clearer with help of guidelines

THURSDAY, Jan. 8 (HealthDay News) -- Appropriate use guidelines for coronary revascularization -- developed jointly by the American College of Cardiology, Society for Cardiovascular Angiography and Interventions, Society of Thoracic Surgeons, American Association for Thoracic Surgery, American Heart Association, and American Society of Nuclear Cardiology -- were released online Jan. 5 in the Journal of the American College of Cardiology, as well as in Catheterization and Cardiovascular Interventions and Circulation: Journal of the American Heart Association.

Manesh R. Patel, M.D., chair of the Coronary Revascularization Writing Group, and colleagues devised 180 clinical scenarios based on everyday experience and scored each one on a scale of one to nine. The score took into account symptoms, non-invasive tests results, coronary anatomy and use of medical therapy.

Those scenarios scoring seven to nine indicate appropriate use of coronary revascularization, while a score of four to six indicates uncertain benefits, and one to three indicate the procedure is not appropriate, the guidelines state.

"In general, the use of coronary revascularization for patients with acute coronary syndromes and combinations of significant symptoms and/or ischemia was viewed favorably," the authors write. "In contrast, revascularization of asymptomatic patients or patients with low-risk findings on non-invasive testing and minimal medical therapy were viewed less favorably. It is anticipated that these results will have an impact on physician decision making and patient education regarding expected benefits from revascularization and will help guide future research."

Several authors report financial relationships with the pharmaceutical and medical industry.

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