García-Villarreal OA

Language: English
References: 8
Page: 1-2
PDF size: 114.90 Kb.

Text Extraction

The “clinical guidelines” entail all available information at the time of writing, concerning a given specific topic. This document can be used in order to make easier, the decision-making process regarding a given patient having a specific pathological condition. This is an extremely demanding process by several multidisciplinary teams working on different areas step by step, looking for the highest quality standards. This is the final aim for the clinical guidelines and is the true standardization of the decision-making process, as far as possible. Theoretically, the more we follow these guidelines, the more we can avert any large errors. We should recognize all involved, for the tremendous effort which has been put into this guidance.
Nevertheless, when it comes to pass in the real world by taking some clinical decisions, this is a totally different kettle of fish. Several deeply unsettling situations and misleading, confusing facts come to light. Why? There is not a simple compelling answer for such a complex situation. On one hand, the available data do not match with the real data and facts coming from a particular working group, Society or Association, other than Europe, US or Canada.

REFERENCES

1. Sousa-Uva M, Neumann FJ, Ahlsson A, et al. ESC Scientific Document Group. 2018 ESC/EACTS Guidelines on myocardial revascularization. Eur J CardiothoracSurg. 2019;55(1):4-90. doi: 10.1093/ejcts/ezy289.

2. Stone GW, Kappetein AP, Sabik JF, et al. Five-Year Outcomes after PCI or CABGfor Left Main Coronary Disease. N Engl J Med. 2019;381(19):1820-30. doi:10.1056/NEJMoa1909406.

3. Ruel M, Falk V, Farkouh ME, Freemantle N, et al. Myocardial RevascularizationTrials. Circulation. 2018;138(25):2943-51. doi: 10.1161/CIRCULATIONAHA.118.035970.

4. Cohen D, Brown E. Is the Tide Turning on the 'Grubby' Affair of EXCEL and theEuropean Guidelines? https://www.medscape.com/viewarticle/939944. Accessedthe Nov 21, 2020.

5. Thuijs DJFM, Kappetein AP, Serruys PW, et al; SYNTAX Extended SurvivalInvestigators. Percutaneous coronary intervention versus coronary artery bypassgrafting in patients with three-vessel or left main coronary artery disease: 10-year follow-up of the multicentre randomised controlled SYNTAX trial. Lancet.2019;394(10206):1325-34. doi: 10.1016/S0140-6736(19)31997-X.

6. García-Villarreal OA. EuroSCORE II. Cómo se usa en la práctica diaria actual.Rev Mex Cardiol 2014; 25(1): 50-1. http://www.scielo.org.mx/pdf/rmc/v25n1/v25n1a10.pdf.

7. https://www.eacts.org/changing-evidence-changing-practice/ Accessed the Nov21, 2020.

8. EACTS/ESC joint statement on the revision of the Guidelines on Myocardial Revascularization.https://www.escardio.org/The-ESC/Press-Office/Press-releases/EACTS-ESC-joint-statement-on-the-revision-of-the-Guidelines-on-Myocardial-Revascularization. Accessed the Nov 21, 2020.