Optimal Management of Patients with Severe Coronary Artery Disease following Multidisciplinary Heart Team Approach—Insights from Tertiary Cardiovascular Care Center

Bibliographic Data

ID15469274
AuthorsSzymon Jonik (0000-0002-9230-5455, Medical University of Warsaw), Michał Marchel (0000-0003-4099-6247, Medical University of Warsaw), Ewa Pędzich (0000-0001-8965-0736, Medical University of Warsaw), Arkadiusz Pietrasik (0000-0002-4876-8858, Medical University of Warsaw), Adam Rdzanek (0000-0002-0235-9696, Medical University of Warsaw), Zenon Huczek (0000-0002-5912-2649, Medical University of Warsaw), Janusz Kochman (0000-0001-8239-8726, Medical University of Warsaw), Monika Budnik (0000-0002-2982-3508, Medical University of Warsaw), Radosław Piątkowski (0000-0003-1344-3348, Medical University of Warsaw), Piotr Ścisło (0000-0002-6361-4136, Medical University of Warsaw), Paweł Czub (0000-0001-7133-2131, Medical University of Warsaw), Radosław Wilimski (0000-0002-3408-3997, Medical University of Warsaw), Jakub Maksym (0000-0003-2053-9946, Medical University of Warsaw), Marcin Grabowski (0000-0003-1447-1818, Medical University of Warsaw), Grzegorz Opolski (0000-0003-4744-2554, Medical University of Warsaw), Tomasz Mazurek (0000-0002-3693-8741, Medical University of Warsaw, corresponding author)
Year2022
Volume19
Issue7
Pages3933-3933
Publication date2022-03-25
Open AccessYes
TypeARTICLE
VenueInternational Journal of Environmental Research and Public Health (JOURNAL)
Journal identifiersISSN: 1661-7827 • E-ISSN: 1660-4601
PublisherMultidisciplinary Digital Publishing Institute (PUBLISHER • CH)
DOI10.3390/ijerph19073933
PMID35409613
OpenAlexW4221058779
LanguageEN
References cited20

Background: The purpose of this retrospective study was to investigate outcomes of patients with severe coronary artery disease (CAD) after implementing various treatment strategies following multidisciplinary Heart Team (MHT) discussion. Methods Primary and secondary endpoints and quality of life during a mean (SD) follow-up of 37 (14) months of patients with severe CAD (three-vessel [3-VD] or/and left main [LM] disease) qualified after MHT discussion to optimal medical treatment (OMT) alone, OMT and coronary artery bypass grafting (CABG), or OMT and percutaneous coronary intervention (PCI) were evaluated. As the primary endpoint, major adverse cardiac or cerebrovascular events (MACCE) (i.e., death from any cause, stroke, myocardial infarction, or repeat/need for revascularization) were considered. Result: From 2016 to 2019, 176 MHT meetings were held, and a total of 1286 participants with severe CAD and completely implemented MHT decisions (OMT, CABG, or PCI for 251, 356, and 679 patients, respectively) were included. The occurrence of the primary endpoint was significantly increased in OMT-group (154 (61.4%) vs. CABG and PCI groups—110 (30.9%) and 302 (44.5%) patients, respectively (p < 0.05). For interventional strategies only—CABG was associated with reduced rates of MACCE and repeat revascularization, while the superiority of PCI for stroke and disabling stroke was observed (p < 0.05). The general health status assessed at the end of the follow-up was significantly better for patients who underwent CABG or PCI than in the OMT group (p < 0.05). Conclusions: In this real-life study, we presented a single-center experience of providing optimal medical care for patients with severe CAD following MHT discussion

Cardiology · Clinical endpoint · Conventional PCI · Coronary artery disease · Myocardial infarction · Percutaneous coronary intervention · Randomized controlled trial · Revascularization · Stent · Stroke (engine · Acute Myocardial Infarction Research · Cardiac Imaging and Diagnostics · Coronary Interventions and Diagnostics · Medicine · Internal Medicine

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