Accurate understanding of the changes in the recommendations on coronary artery bypass grafting and radial artery in the 2021 ACC/AHA/SCAI Guideline For Coronary Artery Revascularization

VernacularTitle:正确认识ACC/AHA/SCAI冠状动脉心肌血运重建指南2021版中对冠状动脉旁路移植术和桡动脉相关推荐的变化
Author: Xin CHEN ¹ ; Zhibing QIU
Author Information

1. 南京医科大学附属南京医院　南京市第一医院心胸血管外科，南京　210006
Keywords: Coronary disease; Coronary artery bypass; Radial artery; guidebooks
From: Chinese Journal of Surgery 2022;60(6):535-539
CountryChina
Language:Chinese
Abstract: The 2021 ACC/AHA/SCAI Guideline For Coronary Artery Revascularization has been brought into focus and widely questioned by multiple associations of cardiac surgeons around the world, in which the class of recommendation (COR) for coronary artery bypass grafting (CABG) was downgraded from Ⅰ to Ⅱb in the treatment of 3 vessel coronary artery disease, and the use of radial artery as CABG conduit was elevated to COR Ⅰ. The ISCHEMIA trial, which was cited by the guidelines as evidence, had obvious selection bias. It did not consider the advantages of long-term patency rate of CABG in patients with high risk factors, and did not define that radial artery bypass has a certain applicable population. Only by widely collecting and carefully selecting evidence and collaborating with cardiac surgeons in the multidisciplinary team of coronary heart disease, the more reasonable and comprehensive guidelines and suggestions could be formed.