Abstract
The appropriateness of coronary revascularization for various clinical scenarios has been reviewed formally by several specialty and subspecialty societies resulting in the formulation of scored appropriateness criteria. The goal of the appropriateness criteria is to guide physician decision-making and future research as well as to label coronary revascularization more clearly for patients and payors in regards to its expected benefits in certain situations. The appropriateness criteria were formulated from a standardized process and are intended to be updated at regular intervals as new data further elucidates the clinical roles of revascularization. Since its last iteration in early 2012, several studies have been published that may further expand scenarios or impact the appropriateness of revascularization in already-established scenarios. The differentiation of appropriateness with particular forms of revascularization has been reserved for specific clinical scenarios where revascularization is generally considered necessary and appropriate. The goals of this review are 1) to highlight aspects of the methodology and development of the coronary revascularization appropriateness criteria, and 2) to focus on the role established specifically for percutaneous coronary intervention within the criteria. Important data published in 2012 that further evaluates the role of percutaneous coronary intervention will also be reviewed with a focus on its potential impact on future iterations of the appropriateness criteria.
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Abbreviations
- ACS:
-
Acute coronary syndrome
- ACUITY:
-
Acute Catheterization and Urgent Intervention Triage strategY
- AUC:
-
Appropriate use criteria
- BMS:
-
Bare metal stent
- CABG:
-
Coronary artery bypass graft
- CAD:
-
Coronary artery disease
- CCS:
-
Canadian Cardiovascular Society
- COURAGE:
-
Clinical Outcomes Utilizing Revascularization and Aggressive Drug Evaluation
- CVA:
-
Cerebrovascular accident
- DES:
-
Drug-eluting stent
- DM:
-
Diabetes mellitus
- FAME:
-
Fractional flow reserve versus Angiography for Multivessel Evaluation
- FFR:
-
Fractional flow reserve
- FREEDOM:
-
Future Revascularization Evaluation in Patients with Diabetes Mellitus: Optimal Management of Multivessel Disease
- HF:
-
Heart failure
- IVUS:
-
Intravascular ultrasound
- LVEF:
-
Left ventricular ejection fraction
- NSTE-ACS:
-
Non ST elevation acute coronary syndrome
- PCI:
-
Percutaneous coronary intervention
- STEMI:
-
ST elevation myocardial infarction
- SYNTAX:
-
The Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery
- TIMI:
-
Thrombolysis in myocardial infarction
References
Papers of particular interest, published recently, have been highlighted as: •• Of major importance
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Matthew R. Summers declares that he has no conflict of interest.
Manesh R. Patel has been a consultant for Genzyme, Jensen, Bayer, and Otsuka. He has received grant support from NHLBI, Johnson and Johnson, and AstraZeneca.
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Summers, M.R., Patel, M.R. Appropriateness of Percutaneous Coronary Intervention: A Review. Curr Cardiol Rep 15, 379 (2013). https://doi.org/10.1007/s11886-013-0379-x
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DOI: https://doi.org/10.1007/s11886-013-0379-x