COMPARISON OF THE EFFECTIVENESS OF CORONARY ARTERY BYPASS GRAFTING AND PERCUTANEOUS CORONARY INTERVENTION IN VARIOUS CLINICAL SITUATIONS

Highlights

The unique clinical profile of each patient and the anatomy of the coronary arteries should be taken into account in the decision-making process when choosing between percutaneous coronary intervention (PCI) or coronary artery bypass grafting (CABG). The SYNTAX scale can help in decision-making by predicting the risk of adverse events and determining the choice between PCI and CABG, but there is a potential benefit from the assessment on the SYNTAX II scale, which allows for better stratification of patients.

Annotation

In the Russian Federation, 46% of all deaths from cardiovascular diseases are due to chronic coronary heart disease. According to the registers, even under the conditions of using modern effective medicines, the 5‑year mortality rate of patients with chronic coronary heart disease remains high and is about 20%. The optimal approach to the treatment of patients with coronary heart disease depends on various factors, such as the degree of prevalence and complexity of the pathological process, patient characteristics and individual preferences. The SYNTAX scale can help in decision-making by predicting the risk of adverse events and determining the choice between PCI and CABG, but there is a potential benefit from the assessment on the SYNTAX II scale, which allows for better stratification of patients. The discussion on the choice between CABG and PCI in various clinical situations will continue to evolve as risk stratification tools, technologies and procedural techniques for both CABG and PCI are improved. Due to continuous progress, revascularization recommendations for specific patient groups will change in the coming years. This literature review has a number of differences from previously published ones, including a wide range of studies, a variety of clinical situations, an assessment of long-term results, a broad analysis of patient subgroups, as well as an assessment of the limitations of existing studies.

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