CIT 2011 in Partnership with TCT:Collaboration and Opportunities——Interview with Prof. Spencer B. King, co-moderator of CIT-TCT Plenary Session
CIT-TCT Plenary Session
State of the Art: PCI Guidelines, Strategies, and Techniques
9:30 AM-12:30 PM, Thursday, March 17, 2011
Plenary Hall A, Level 4, CNCC
International Circulation: The recommendation of revascularization for stable coronary heart disease was updated in the ESC2010 guideline and this issue will be one of the 6 themes during CIT-TCT plenary session. Would you please give Chinese physicians some take-home messages about this issue?
Prof. King: The important factors in considering revascularization for stable patients are whether the patient’s prognosis be improved and can their symptoms be improved. These are the two elements that go into decision making. Therefore, for all patients, a careful assessment of their symptomatology and the opportunity to improve it with revascularization should be made. Also, a careful risk assessment should be carried out because we like to know what the risk of cardiac events is in this population. The first decision to make is whether revascularization is appropriate and that appropriateness is based on those two elements. In the European guidelines the indication for improving symptoms and the indication for improving prognosis are judged separately. I think that is a very wise way to approach the decision making.
If revascularization is judged to be appropriate, then the question is what form of revascularization should be used. We have a great deal of evidence that informs our judgment about the use of percutaneous intervention or surgical intervention. The European guidelines recommend a joint decision by a heart team, which in some cases represents a non-invasive cardiologist, an invasive cardiologist, and a surgeon. This is often logistically difficult to arrange but the perspective of all three disciplines need to be considered.