When is it the time for medical treatment, percutaneous coronary intervention or aortocoronary bypass surgery?

GROUND: 3% to 4% of the population suffers from chronic coronary artery disease (CAD). Primary care physicians, internists, cardiologists, and cardiac surgeons are involved in their long-term care. This article presents a complementary care pathway that integrates two apparently competing treatment options, aortocoronary bypass surgery (ACB) and percutaneous coronary intervention (PCI).

Together with lifestyle changes and medical therapy, these treatments reduce morbidity and mortality and improve quality of life. METHODS: This article was written by cardiac surgeons and cardiologists on the basis of the current treatment guidelines for coronary artery disease, a selective review of the literature (randomized, controlled trials and registry data), and a process of interdisciplinary consensus building. RESULTS AND CONCLUSIONS: Lifestyle changes can reduce cardiovascular risk factors, improve quality of life, and lower cardiovascular morbidity and mortality.

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