Abstract
Heart of the matter
Highlights
In the first issue of this new journal Denvir and colleagues [1] touch on a subject which is probably the single most important threat to cardiac surgery- the increasing tendency of some cardiologists to treat patients with severe coronary artery disease without a surgical opinion
Since 1998 in the UK the ratio of PCI:CABG has increased from 1:1 to almost 3:1. This change in practice is likely to continue or even accelerate as the recent European Society of Cardiology [3] and the American Heart Association [4] guidelines recommend that PCI can be considered as the initial treatment strategy for most patients with multi-vessel disease
The guidelines are based on a fundamentally flawed misunderstanding and/or misinterpretation of 15 randomised trials of PCI versus CABG. These trials reported that while CABG reduced the need for further intervention almost fourfold in patients with 'multi-vessel' disease there was no difference in survival between PCI and CABG
Summary
In the first issue of this new journal Denvir and colleagues [1] touch on a subject which is probably the single most important threat to cardiac surgery- the increasing tendency of some cardiologists to treat patients with severe coronary artery disease without a surgical opinion. This change in practice is likely to continue or even accelerate as the recent European Society of Cardiology [3] and the American Heart Association [4] guidelines recommend that PCI can be considered as the initial treatment strategy for most patients with multi-vessel disease.
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