October 6, 2020
EACTS and ESC to Collaborate on Revision of Myocardial Revascularization Guidelines
October 6, 2020—The European Society of Cardiology (ESC) and the European Association for Cardiothoracic Surgery (EACTS) issued a joint statement advising that they have agreed to collaborate in reviewing the most up-to-date evidence for the treatment of patients with left main coronary artery stenosis as soon as it is available.
In particular, the organizations wish to review their joint guidelines, published in August 2018, in the light of emerging, longer-term outcome data from the trials of coronary artery bypass graft surgery versus percutaneous coronary interventions, and an independent patient-level meta-analysis of these trials that is currently underway. The two organizations stated they will establish a “robust and transparent process to review this new evidence.”
In the meantime, ESC and EACTS recommend that treatment decisions for individual patients take into account all available published information. They noted that the ESC/EACTS Guidelines on Myocardial Revascularization state that a discussion within the heart team and with the patient should be the basis of all treatment decisions.
The 2018 ESC/EACTS Guidelines on myocardial revascularization were published by Professor Franz-Josef Neumann, MD, ESC Chairperson of the Guidelines Task Force, and Professor Miguel Sousa-Uva, MD, EACTS Chairperson of the Guidelines Task Force, et al in European Heart Journal (2019;40:87–165).
The announcement comes after the following events as reported in Cardiac Interventions Today:
- On December 9, 2019, EACTS announced its withdrawal of support from the guidelines related to myocardial revascularization for left main coronary artery disease in response to the report of the United Kingdom’s BBC Newsnight investigation on the EXCEL trial. At that time, the ESC rejected the BBC report’s claim that the guidelines may have caused harm to patients and stands by the guidelines, which ESC says were based on more than the EXCEL trial.
- On December 12, 2019, Gregg W. Stone, MD, et al on behalf of the EXCEL leadership issued a response to the news reports and society statements questioning the conduct and data of the EXCEL trial.
- On January 3, 2020, the Cardiovascular Research Foundation announced that it commissioned an independent review of the EXCEL trial.
- On January 7, 2020, EACTS announced it had offered to assist the principal investigators of the EXCEL trial to resolve concerns that have been raised about the trial.
[More coverage on this topic available here.]