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Canadian Journal of Cardiology

Novel Approaches to Define Outcomes in Coronary Revascularization

  • Author Footnotes
    ∗ These authors contributed equally to the redaction of this report.
    Fabrice Ieroncig
    Footnotes
    ∗ These authors contributed equally to the redaction of this report.
    Affiliations
    Cardiology, University of Montreal, Montreal, Quebec, Canada
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  • Author Footnotes
    ∗ These authors contributed equally to the redaction of this report.
    Jean-Bernard Breau
    Footnotes
    ∗ These authors contributed equally to the redaction of this report.
    Affiliations
    Cardiology, University of Montreal, Montreal, Quebec, Canada
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  • Guillaume Bélair
    Affiliations
    Cardiology, University of Montreal, Montreal, Quebec, Canada
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  • Louis-Philippe David
    Affiliations
    Division of Cardiology, Saint-Paul’s Hospital, Vancouver, British Columbia, Canada
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  • Nicolas Noiseux
    Affiliations
    Division of Cardiovascular Surgery, Centre Hospitalier Universitaire de Montréal, Montréal, Quebec, Canada
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  • Raja Hatem
    Affiliations
    Division of Interventional Cardiology, Hôpital du Sacré-Coeur, Montréal, Quebec, Canada
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  • Author Footnotes
    ‡ This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Robert Avram
    Correspondence
    Corresponding author: Dr Robert Avram, 505 Parnassus Ave, San Francisco, California 94143, USA. Tel.: +1-415-936-3062.
    Footnotes
    ‡ This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
    Affiliations
    Division of Cardiology, Department of Medicine, University of California, San Francisco, San Francisco, California, USA
    Search for articles by this author
  • Author Footnotes
    ∗ These authors contributed equally to the redaction of this report.
    ‡ This author takes responsibility for all aspects of the reliability and freedom from bias of the data presented and their discussed interpretation.
Published:December 14, 2018DOI:https://doi.org/10.1016/j.cjca.2018.12.016

      Abstract

      Coronary revascularization is done to alleviate the patient symptoms or to improve prognosis. Despite these clinical indications, significant variability exists in the risk assessment tools used to select patients for coronary revascularization, to the extent of revascularization performed and, in our approaches to define “optimal” revascularization. The goal of this review is to evaluate novel approaches that can assess coronary artery disease before and after revascularization, define the thresholds of these approaches that have been shown to improve morbidity and mortality, and highlight future directions for research in this area. The novel approaches defining coronary revascularization described in this review are split among quality of life metrics, risk scores, noninvasive imaging outcomes, invasive imaging outcomes, and physiological measurements.

      Résumé

      La revascularisation coronarienne est faite pour améliorer les symptômes des patients ou améliorer leur pronostic. Malgré ces indications cliniques, il existe des variations significatives dans les outils d’évaluations des risques utilisés pour sélectionner les patients pour une revascularisation coronarienne, l'ampleur de la revascularisation effectuée et la manière de définir une revascularisation optimale. Le but de cette revue est de décrire de nouvelles approches qui peuvent évaluer l’impact de la maladie coronarienne avant et après une revascularisation, définir les seuils associés avec ces nouvelles approches menant à une réduction de la morbidité et mortalité, et décrire les études à venir dans ces domaines. Les nouvelles approches déterminant la revascularisation coronarienne sont divisées en paramètres évaluant la qualité de vie, échelles de risque, résultats d’imagerie non invasive, résultats d’imagerie invasives et en mesures physiologiques.
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