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Overview: Japanese guidelines for myocardial revascularization to treat stable ischemic heart disease 2012

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Abstract

Since its introduction in the early 1970s, coronary artery bypass grafting (CABG) has become an established surgical treatment for coronary artery disease (CAD). Percutaneous coronary intervention (PCI), first clinically applied in 1977, was promoted as an alternative to CABG during the mid-1980s. Along with the nationwide expansion of PCI, the ratio of PCI to CABG has exceeded 6–7:1. The Japanese Circulation Society (JCS) published “Guidelines on elective coronary intervention, including coronary artery bypass grafting (CABG), for ischemic heart disease in 2000” and “Guidelines on the selection of bypass conduits and operative procedures in coronary artery bypass grafting for ischemic heart disease”. The society intended to revise these guidelines in 2010 and to issue two new guidelines specific either to PCI or CABG. They also planned to issue joint guidelines for myocardial revascularization and PCI/CABG, which are primary indications for patients with stable CAD, especially with those with more complex left main trunk disease and/or multi-vessel disease. The scientific committee of JCS established the “Council for myocardial revascularization” that consisted of experts including interventional and non-interventional cardiologists, cardiac surgeons and physicians specialized in diabetes or nephrology selected by medical and surgical societies. After over 10 rounds of meetings, the Council prepared primary guidelines for myocardial revascularization to treat stable CAD, PCI/CABG. These guidelines consist of (1) Statements about myocardial revascularization, (2) Interpretation of the statements and (3) Indications for PCI/CABG including a table.

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References

  1. Gruentzig AR, Senning A, Siegenthaler WE. Nonoperative dilatation of coronary-artery stenosis. Percutaneous transluminal coronary angioplasty. N Engl J Med. 1979;301:61–8.

    Article  Google Scholar 

  2. Benetti FJ, Naselli G, Wood M, et al. Direct myocardial revascularization without extracorporeal circulation: experience in 700 patients. Chest. 1991;100:312–6.

    Article  PubMed  CAS  Google Scholar 

  3. Buffolo E, de Andrade JCS, Rodrigues EJN, et al. Coronary artery bypass surgery without cardiopulmonary bypass. Ann Thorac Surg. 1996;61:63–6.

    Article  PubMed  CAS  Google Scholar 

  4. Puskas JD, Williams WH, Mahoney EM, et al. Off-pump vs. conventional coronary artery bypass grafting: early and 1-year graft patency, cost, and quality-of-life outcomes: a randomized trial. JAMA. 2004;291:1841–9.

    Article  PubMed  CAS  Google Scholar 

  5. Yusuf S, Zucker D, Peduzzi P, Fisher LD, Takaro T, Kennedy JW, Davis K, Killip T, Passamani E, Norris R, Morris C, Mathur V, Varnauskas V, Chalmers TC. Effect of coronary artery bypass graft surgery on survival: overview of 10-year results from randomized trials by the Coronary Artery Bypass Graft Surgery Trialists Collaboration. Lancet. 1994;344:563–70.

    Article  PubMed  CAS  Google Scholar 

  6. Hueb W, Lopes NH, Gersh BJ, Soares P, Machado LA, Jatene FB, Oliveira SA, Ramires JA. Five-year follow-up of the Medicine, Angioplasty, or Surgery Study (MASS II): a randomized controlled clinical trial of 3 therapeutic strategies for multivessel coronary artery disease. Circulation. 2007;115:1082–9.

    Article  PubMed  Google Scholar 

  7. Hueb W, Lopes N, Gersh BJ, Soares PR, Ribeiro EE, Pereira AC, Favarato D, Rocha AS, Hueb AC, Ramires JA. Ten-year follow-up survival of the Medicine, Angioplasty, or Surgery Study (MASS II): a randomized controlled clinical trial of 3 therapeutic strategies for multivessel coronary artery disease. Circulation. 2010;122:949–57.

    Article  PubMed  Google Scholar 

  8. Taggart DP, D’Amico R, Altman DG. Effect of arterial revascularisation on survival: a systematic review of studies comparing bilateral and single internal mammary arteries. Lancet. 2001;358:870–5.

    Article  PubMed  CAS  Google Scholar 

  9. Suma H, Fukumoto H, Takeuchi A. Coronary artery bypass grafting by utilizing in situ right gastroepiploic artery: basic study and clinical application. Ann Thorac Surg. 1987;44:394–7.

    Article  PubMed  CAS  Google Scholar 

  10. BARI 2D Study Group, Frye RL, August P, Brooks MM, Hardison RM, Kelsey SF, MacGregor JM, Orchard TJ, Chaitman BR, Genuth SM, Goldberg SH, Hlatky MA, Jones TL, Molitch ME, Nesto RW, Sako EY, Sobel BE. A randomized trial of therapies for type 2 diabetes and coronary artery disease. N Engl J Med. 2009;360:2503–15.

    Article  PubMed  CAS  Google Scholar 

  11. Chaitman BR, Hardison RM, Adler D, Gebhart S, Grogan M, Ocampo S, Sopko G, Ramires JA, Schneider D. Bypass Angioplasty Revascularization Investigation 2 Diabetes (BARI 2D) Study Group. The Bypass Angioplasty Revascularization Investigation 2 Diabetes randomized trial of different treatment strategies in type 2 diabetes mellitus with stable ischemic heart disease: impact of treatment strategy on cardiac mortality and myocardial infarction. Circulation. 2009;120:2529–40.

    Article  PubMed  CAS  Google Scholar 

  12. Keely EC, Boura JA, Grines CL. Primary angioplasty versus intravenous thrombolytic therapy for acute myocardial infarction: a quantitative review of 23 randomised trials. Lancet. 2003;361:13–20.

    Article  Google Scholar 

  13. Mehta SR, Cannon CP, Fox KA, et al. Routine vs selective invasive strategies in patients with acute coronary syndromes: a collaborative meta-analysis of randomized trials. JAMA. 2005;293:2908–17.

    Article  PubMed  CAS  Google Scholar 

  14. Katritsis DG, Ioannidis JPA. Percutaneous coronary intervention versus conservative therapy in nonacute coronay artery disease: a meta-analysis. Circulation. 2005;111:2906–12.

    Article  PubMed  Google Scholar 

  15. Boden WE, O’Rourke RA, Teo KK, Hartigan PM, Maron DJ, Kostuk WJ, Knudtson M, Dada M, Casperson P, Harris CL, Chaitman BR, Shaw L, Gosselin G, Nawaz S, Title LM, Gau G, Blaustein AS, Booth DC, Bates ER, Spertus JA, Berman DS, Mancini GB. COURAGE Trial Research Group. Optimal medical therapy with or without PCI for stable coronary disease. N Engl J Med. 2007;356:1506–16.

    Article  Google Scholar 

  16. Kirtane AJ, Gupta A, Iyengar S, Moses JW, Leon MB, Applegate R, Brondie B, Hannan E, Harjai K, Jensen LO, Park SJ, Perry R, Racz M, Saia F, Tu JV, Waksman R, Lansky AJ, Mehran R, Stone GW. Safety and efficacy of drug-eluting and bare metal stents: comprehensive meta-analysis of randomized trials and observational studies. Circulation. 2009;119:3198–206.

    Article  PubMed  CAS  Google Scholar 

  17. Trikalinos TA, Alsheikh-Ali AA, Tatsioni A, Nallamothu BK, Kent DM. Percutaneous coronary interventions for non-acute coronary artery disease: a quantitative 20-year synopsis and a network meta-analysis. Lancet. 2009;373:911–8.

    Article  PubMed  Google Scholar 

  18. Levine GN, Bates ER, Blankenship JC, et al. ACCF/AHA/SCAI Guideline for percutaneous coronary intervention. A report of the American College of Cardiology Foundation/American Heart Association Task Force on Practical Guidelines and the Society for Cardiovascular Angiography and Interventions. J Am Coll Cardiol. 2011;58(24):e44–122. doi:10.1016/j.jacc.2011.08.007.

    Article  PubMed  Google Scholar 

  19. Taggart DP. PCI or CABG in coronary artery disease? Lancet. 2009;373:1150–2.

    Article  PubMed  Google Scholar 

  20. Hlatky MA, Boothroyd DB, Bravata DM, et al. Coronary artery bypass surgery compared with percutaneous coronary interventions for multivessel disease: a collaborative analysis of individual patient data from ten randomised trials. Lancet. 2009;373:1190–7.

    Article  PubMed  Google Scholar 

  21. European Association for Percutaneous Cardiovascular Interventions, Wijns W, Kolh P, Danchin N, et al. Guidelines on myocardial revascularization: The Task Force on Myocardial Revascularization of the European Society of Cardiology (ESC) and the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J. 2010;31(20):2501–55.

    Article  PubMed  Google Scholar 

  22. Brener SJ, Lytle BW, Casserly IP, Schneider JP, Topol EJ, Lauer MS. Propensity analysis of long-term survival after surgical or percutaneous revascularization in patients with multivessel coronary artery disease and high-risk features. Circulation. 2004;109:2290–5.

    Article  PubMed  Google Scholar 

  23. Hannan EL, Racz MJ, Walford G, et al. Long-term outcomes of coronary-artery bypass grafting versus stent implantation. N Engl J Med. 2005;352:2174–83.

    Article  PubMed  CAS  Google Scholar 

  24. Malenka DJ, Leavitt BJ, Hearne MJ, Northern New England Cardiovascular Disease Study Group, et al. Comparing long-term survival of patients with multivessel coronary disease after CABG or PCI: analysis of BARI-like patients in northern New England. Circulation. 2005;112(suppl 9):1371–6.

    Google Scholar 

  25. Smith PK, Califf RM, Tuttle RH, et al. Selection of surgical or percutaneous coronary intervention provides differential longevity benefit. Ann Thorac Surg. 2006;82:1420–8.

    Article  PubMed  Google Scholar 

  26. Tl Bair, Muhlestein JB, May HT, et al. Surgical revascularization is associated with improved long-term outcomes compared with percutaneous stenting in most subgroups of patients with multivessel coronary artery disease: results from the Intermountain Heart Registry. Circulation. 2007;116(Suppl 11):1226–31.

    Google Scholar 

  27. Hannan EL, Wu C, Walford G, et al. Drug-eluting stents vs. coronary-artery bypass grafting in multivessel disease. N Engl J Med. 2008;358:331–41.

    Article  PubMed  CAS  Google Scholar 

  28. Kimura T, Morimoto T, Furukawa Y, Nakagawa Y, Shizuta S, Ehara N, Taniguchi R, Doi T, Nishiyama K, Ozasa N, Saito N, Hoshino K, Mitsuoka H, Abe M, Toma M, Tamura T, Haruna Y, Imai Y, Teramukai S, Fukushima M, Kita T. Long-term outcomes of coronary-artery bypass graft surgery versus percutaneous coronary intervention for multivessel coronary artery disease in the bare-metal stent era. Circulation. 2008;118(14 Suppl):S199–209.

    Article  PubMed  Google Scholar 

  29. Marui A, Kimura T, Tanaka S, Furukawa Y, Kita T, Sakata R and on behalf of the CREDO-Kyoto Investigators. Significance of off-pump coronary artery bypass grafting compared with percutaneous coronary intervention: a propensity score analysis. Eur J Cardiothorac Surg (in press).

  30. Serruys PW, Morice MC, Kappetein AP, Colombo A, Holmes DR, Mack MJ, Ståhle E, Feldman TE, van den Brand M, Bass EJ, Van Dyck N, Leadley K, Dawkins KD, SYNTAX Investigators. Percutaneous coronary intervention versus coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med. 2009;360:961–72.

    Article  PubMed  CAS  Google Scholar 

  31. Kappetein AP, Feldman TE, Mack MJ, Morice MC, Holmes DR, Ståhle E, Dawkins KD, Mohr FW, Serruys PW, Colombo A. Comparison of coronary bypass surgery with drug-eluting stenting for the treatment of left main and/or three-vessel disease: 3-year follow-up of the SYNTAX trial. Eur Heart J (in press).

  32. Takaro T, Peduzzi P, Detre KM, et al. Survival in subgroups of patients with left main coronary artery disease. Veterans Administration Cooperative Study of Surgery for Coronary Arterial Occlusive Disease. Circulation. 1982;66:14–22.

    Article  PubMed  CAS  Google Scholar 

  33. Taylor HA, Deumite NJ, Chaitman BR, et al. Asymptomatic left main coronary artery disease in the Coronary Artery Surgery Study (CASS) registry. Circulation. 1989;79:1171–9.

    Article  PubMed  CAS  Google Scholar 

  34. Caracciolo EA, Davis KB, Sopko G, et al. Comparison of surgical and medical group survival in patients with left main coronary artery disease. Long-term CASS experience. Circulation. 1995;91:2325–34.

    Article  PubMed  CAS  Google Scholar 

  35. Morice MC, Serruys PW, Kappetein AP, et al. Outcomes in patients with de novo left main disease treated with either percutaneous coronary intervention using paclitaxel-eluting stents or coronary artery bypass graft treatment in the Synergy between Percutaneous Coronary Intervention with TAXUS and Cardiac Surgery (SYNTAX) trial. Circulation. 2010;121:2645–53.

    Article  PubMed  CAS  Google Scholar 

  36. Gersh BJ, Frye RL. Methods of coronary revascularization-things may not be as they seem. N Engl J Med. 2005;352:2235–7.

    Article  PubMed  CAS  Google Scholar 

  37. Sakata R, Fujii Y, Kuwano H. Thoracic cardiovascular surgery in Japan during, Annual report by the Japanese Association for Thoracic Surgery. Gen Thorac Cardiovasc Surg. 2009;2011(59):636–67.

    Google Scholar 

  38. The Bypass Angioplasty Revascularization Investigation (BARI) Investigators. Comparison of coronary artery bypass surgery with angioplasty in patients with multivessel disease. N Engl J Med. 1996;335:217–25.

    Article  Google Scholar 

  39. Niles NW, McGrath PD, Malenka D, et al. Survival of patients with diabetes and multivessel coronary artery disease after surgical or percutaneous coronary revascularization: results of a large regional prospective study. J Am Coll Cardil. 2001;37:1008–15.

    Article  CAS  Google Scholar 

  40. Graham MM, Ghali WA, Faris PD, The Alberta Provincial Project for Outcomes Assessment in Coronary Heart Disease (APPROACH) Investigators, et al. Survival after coronary revascularization in the elderly. Circulation. 2002;105:2378–84.

    Article  PubMed  Google Scholar 

  41. Dacey LJ, Likosky DS, Ryan TJ, et al. Long-term survival after surgery versus percutaneous intervention in octogenarians with multivessel coronary disease. Ann Thorac Surg. 2007;84:1904–11.

    Article  PubMed  Google Scholar 

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Correspondence to Masami Ochi.

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This article covers the history that led to the current Japanese guidelines.

The review was submitted at the invitation of the editorial committee.

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Ochi, M. Overview: Japanese guidelines for myocardial revascularization to treat stable ischemic heart disease 2012. Gen Thorac Cardiovasc Surg 61, 246–253 (2013). https://doi.org/10.1007/s11748-012-0182-4

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