Published on:
    Journal of Cardiovascular Disease Research, 2010; 1(2):54-58
    INVITED COMMENT | doi:10.1016/S0975-3583(10)12003-8

    Percutaneous coronary intervention vs coronary artery bypass grafting in the management of chronic stable angina: A critical appraisal

    Authors:

    Alok Kumar Singh
    Department of Cardiology, C S M Medical University, Lucknow - 226 003, India.
     

    Abstract:

    Chronic stable angina is a clinical expression of myocardial ischemia associated with  xed atherosclerotic coronary stenosis, which prevents the adaptation of coronary circulation resulting in an increased oxygen requirement. We recommend that once the diagnosis of chronic stable angina is made,  rst every patient should be offered the optimal medical therapy, including ACE inhibitors, beta-blockers, statins, and nitrates. If the patients’ symptoms are not controlled in spite of these drugs being used in maximum tolerated dosages, then these patients should be subjected to coronary angiography. If a patient shows a single- or double-vessel disease, then PCI should be offered. On the contrary, if the coronary angiogram shows a triple-vessel disease and left main disease, then one has to look for comorbidities that put the patient at a higher risk of CABG and the patient should be treated with PCI. Other patients with left main and triple-vessel disease having diabetes and left ventricular dysfunction should go directly for surgical revascularization. Overall, health related quality of life ( HRQoL) is similar in both PCI and CABG.

    Key words: Coronary artery bypass grafting, percutaneous coronary intervention, chronic stable angina, revascularization.