Surgical treatment of acute coronary syndrome without ST elevation

Authors: Zhalilov A.K., Salomov M.A.

Company: Bakoulev National Medical Research Center for Cardiovascular Surgery, Moscow, 121552, Russian Federation

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Type:  Reviews


DOI: https://doi.org/10.24022/1997-3187-2020-14-1-49-57

For citation: Zhalilov A.K., Salomov M.A. Surgical treatment of acute coronary syndrome without ST elevation. Creative Cardiology. 2020; 14 (1): 49–57 (in Russ.). DOI: 10.24022/1997-3187-2020-14-1-49-57

Received / Accepted:  05.03.2020/11.03.2020

Keywords: coronary artery bypass surgery acute coronary syndrome myocardial infarction angioplasty shunting emergency cardiology diabetes European Society of Cardiology

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Abstract

Patients with non-ST-elevation acute coronary syndromes (NSTE-ACS) are very heterogeneous group with different risks of cardiovascular events. Invasive coronary angiography is still the main diagnostic tool in these patients. Percutaneous coronary intervention (PCI) has the advantage of faster revascularization, lower risk of stroke and early discharge. Coronary artery bypass grafting (CABG) allows a complete revascularization, consequently, reduces the need for a repeat revascularization.
Approximately 10% of NSTE-ACS patients may require CABG during index hospitalization. NSTE-ACS patients undergoing CABG represent a challenging group, mainly because of balancing between ischaemic and bleeding risks in terms of surgery timing and perioperative antithrombotic therapy. Thus, whether to perform CABG or PCI in patients with NSTE-ACS should be discussed individually by Heart team. There is limited data comparing effectiveness of CABG versus PCI with drug-eluting stents in patients with NSTE-ACS. This article presents an overview of current clinical data regarding the role of various myocardial revascularization methods in patients with NSTE-ACS.

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About Authors

  • Adkham K. Zhalilov, Cand. Med. Sc., Applicant, ORCID
  • Makhmadsharif A. Salomov, Researcher, ORCID

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, Director of Bakoulev National Medical Research Center for Cardiovascular Surgery