2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization

This is the guideline where the US and Europe visibly part company. Reading ISCHEMIA and the contemporary trial data strictly, the writing committee reduced CABG for survival in three-vessel disease with preserved ejection fraction to Class 2b ('may be reasonable') — the ESC/EACTS 2018 document still gives CABG a Class I in that setting — and the demotion was contentious enough that the surgical societies withheld their endorsement. Left main disease runs the other way: PCI is 2a in anatomically low-to-medium-complexity left main, where ESC/EACTS grants Class I at SYNTAX ≤22. Both agree on radial access, on the radial artery as the second conduit and on staged complete revascularisation in STEMI. The register's revascularisation trials are grouped below.

This guideline cites 19 of the 199 landmark trials in our Cardiology register.

Source

Lawton JS, Tamis-Holland JE, et al. Circulation. 2022;145(3):e18–e114.

DOI

10.1161/CIR.0000000000001038