Optimal Management of Patients with Severe Coronary Artery Disease following Multidisciplinary Heart Team Approach—Insights from Tertiary Cardiovascular Care Center

Szymon Jonik, Michał Marchel, Ewa Pędzich-Placha, Arkadiusz Pietrasik, Adam Rdzanek, Zenon Huczek, Janusz Kochman, Monika Budnik, Radosław Piątkowski, Piotr Scisło, Paweł Czub, Radosław Wilimski, Jakub Maksym, Marcin Grabowski, Grzegorz Opolski and Tomasz Mazurek
Additional contact information
Szymon Jonik: Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Michał Marchel: Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Ewa Pędzich-Placha: Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Arkadiusz Pietrasik: Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Adam Rdzanek: Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Zenon Huczek: Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Janusz Kochman: Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Monika Budnik: Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Radosław Piątkowski: Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Piotr Scisło: Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Paweł Czub: Department of Cardiac Surgery, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Radosław Wilimski: Department of Cardiac Surgery, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Jakub Maksym: Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Marcin Grabowski: Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Grzegorz Opolski: Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland
Tomasz Mazurek: Department of Cardiology, Medical University of Warsaw, Banacha 1a Str., 01-267 Warsaw, Poland

IJERPH, 2022, vol. 19, issue 7, 1-12

Abstract: Background: The purpose of this retrospective study was to investigate outcomes of patients with severe coronary artery disease (CAD) after implementing various treatment strategies following multidisciplinary Heart Team (MHT) discussion. Methods Primary and secondary endpoints and quality of life during a mean (SD) follow-up of 37 (14) months of patients with severe CAD (three-vessel [3-VD] or/and left main [LM] disease) qualified after MHT discussion to optimal medical treatment (OMT) alone, OMT and coronary artery bypass grafting (CABG), or OMT and percutaneous coronary intervention (PCI) were evaluated. As the primary endpoint, major adverse cardiac or cerebrovascular events (MACCE) (i.e., death from any cause, stroke, myocardial infarction, or repeat/need for revascularization) were considered. Result: From 2016 to 2019, 176 MHT meetings were held, and a total of 1286 participants with severe CAD and completely implemented MHT decisions (OMT, CABG, or PCI for 251, 356, and 679 patients, respectively) were included. The occurrence of the primary endpoint was significantly increased in OMT-group (154 (61.4%) vs. CABG and PCI groups—110 (30.9%) and 302 (44.5%) patients, respectively ( p < 0.05). For interventional strategies only—CABG was associated with reduced rates of MACCE and repeat revascularization, while the superiority of PCI for stroke and disabling stroke was observed ( p < 0.05). The general health status assessed at the end of the follow-up was significantly better for patients who underwent CABG or PCI than in the OMT group ( p < 0.05). Conclusions: In this real-life study, we presented a single-center experience of providing optimal medical care for patients with severe CAD following MHT discussion.

Keywords: multidisciplinary heart team; multivessel coronary artery disease; coronary artery bypass grafting; percutaneous coronary intervention; optimal medical therapy (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2022
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://www.mdpi.com/1660-4601/19/7/3933/pdf (application/pdf)
https://www.mdpi.com/1660-4601/19/7/3933/ (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:gam:jijerp:v:19:y:2022:i:7:p:3933-:d:779678

Access Statistics for this article

IJERPH is currently edited by Ms. Jenna Liu

More articles in IJERPH from MDPI
Bibliographic data for series maintained by MDPI Indexing Manager ().