Coronary Revascularization Advantages And Disadvantages

Important concerns about overuse of invasive diagnostic imaging techniques and subsequent implications for patient safety have repeatedly been expressed.1 Expenditures in healthcare related to invasive imaging are increasing dramatically, especially in the field of cardiovascular disease.2,3 To assess the extent of coronary stenosis, diagnostic cardiac catheterization performed with invasive coronary angiography (ICA) is currently widely used as gold standard for diagnosing CAD. As mentioned previously, due to the high-costs and the risks for acute surgical complications associated with ICA, the concerns raised by the overuse of this invasive surgical diagnostic method affected its sustainability.5,6 In this context, complementary methods were

Evidence of the AUC for validating this approach have been supported academically, and the use of AUC for guiding ICA and subsequent revascularization has been associated with a reduction in mortality.8 However, interventional cardiology guidelines and AUC for coronary revascularization exclude considerations related to patient preference. Rather, physicians typically choose evidence-based treatment strategies for their patients, without engaging in a discussion about what would be the best alternative for them. In a patient-centric era of care, the advantages and disadvantages of the various alternatives should be discussed in detail. Current AUC do not account for personal contexts and perspectives, and usually disregard the fundamental role of patient preference as to which treatment strategy should be taken. Recognizing this malpractice, guidelines for the diagnosis and management of patients with stable ischemic heart disease documented the importance accounting for patients’ perspectives to help inform referring physicians about treatment strategies that are preferred by patients (Fihn et al. 2012; Nishimura et al., 2014; Mancini et al.,