2026-04-14T04:55:08Zhttps://recercat.cat/oai/request
oai:recercat.cat:2072/4587042025-08-29T15:10:07Zcom_2072_98col_2072_378192
RECERCAT author Gabaldon-Perez, Ana author Marcos-Garces, Victor author Gavara Doñate, Jose author Rios-Navarro, Cesar author Miñana, Gema author Bayés-Genís, Antoni author Husser, Oliver author Sanchis, Juan author Núñez, Julio author Chorro, Francisco J author Bodi, Vicente author Universitat Autònoma de Barcelona. Departament de Medicina 2021 Ischemic heart disease (IHD) persists as the leading cause of death in the Western world. In recent decades, great headway has been made in reducing mortality due to IHD, based around secondary prevention. The advent of coronary revascularization techniques, first coronary artery bypass grafting (CABG) surgery in the 1960s and then percutaneous coronary intervention (PCI) in the 1970s, has represented one of the major breakthroughs in medicine during the last century. The benefit provided by these techniques, especially PCI, has been crucial in lowering mortality rates in acute coronary syndrome (ACS). However, in the setting where IHD is most prevalent, namely chronic coronary syndrome (CCS), the increase in life expectancy provided by coronary revascularization is controversial. Over more than 40 years, several clinical trials have been carried out comparing optimal medical treatment (OMT) alone with a strategy of routine coronary revascularization on top of OMT. Beyond a certain degree of symptomatic improvement and lower incidence of minor events, routine invasive management has not demonstrated a convincing effect in terms of reducing mortality in CCS. Based on the accumulated evidence more than half a century after the first revascularization procedures were used, invasive management should be considered in those patients with uncontrolled symptoms despite OMT or high-risk features related to left ventricular function, coronary anatomy, or functional assessment, taking into account the patient expectations and preferences. open access Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. https://creativecommons.org/licenses/by/4.0/ Ischemic heart disease Chronic coronary syndrome Coronary artery disease Myocardial revascularization Ischemia Stress cardiac magnetic resonance Coronary Revascularization and Long-Term Survivorship in Chronic Coronary Syndrome Article