Есть ли место мультидисциплинарному подходу (HEART TEAM) к выбору способа реваскуляризации миокарда у пациентов с острыми коронарными синдромами?

В обзорной статье на основании зарубежных и отечественных исследований, рекомендаций европейского и североамериканского кардиологических и хирургических сообществ обобщены позиции экспертов в отношении места мультидисциплинарной команды в выборе тактики лечения пациентов с различными формами ишемической болезни сердца. Даны позиции современных клинических рекомендаций в отношении чрескожного коронарного вмешательства и коронарного шунтирования при остром коронарном синдроме. Представлены перспективные позиции по оптимизации процесса принятия решения мультидисциплинарной командой при рассмотрении сложных пациентов.

1. Комплекс практических мер по ведению пациентов с сердечно-сосудистыми заболеваниями на уровне первичной медико-санитарной помощи [HEARTS: technical package for cardiovascular disease management in primary health care]. Всемирная организация здравоохранения, 2018, ISBN: 978-92-4-451137-4. https://apps.who.int/iris/bitstream/handle/10665/311510/9789244511374-rus.pdf?ua=1.

2. Mesana T. Heart Teams for Treatment of cardiovascular disease. Springer Nature Switzerland AG, 2019. р.158

3. Lancellotti P, Ancion A, Davin L, et al. Le “Heart Team”: définition et organisation. Point de Vue du Cardiologue [The heart team: definition and organization. Point of view of the cardiologist]. Rev Med Liege. 2019 Sup;74(S1):S5-S9. (In French).

4. Neumann FJ, Sousa-Uva M, Ahlsson A, et al. 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J. 2019;40(2):87-165.

5. Collet JP, Thiele H, Barbato E, et al.; ESC Scientific Document Group. 2020 ESC Guidelines for the management of acute coronary syndromes in patients presenting without persistent ST-segment elevation. Eur Heart J. 2020:ehaa575. doi:10.1093/eurheartj/ehaa575. Epub ahead of print.

6. 2014 AHA/ACC Guideline for the Management of Patients With Non-ST-Elevation Acute Coronary Syndromes. A Report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines. JACC. 2014;64(24). doi:10.1016/j.jacc.2014.09.017.

7. AHA/ACC/HHS Strategies to Enhance Application of Clinical Practice Guidelines in Patients With Cardiovascular Disease and Comorbid Conditions. JACC. 2014;64(17). doi:10.1016/j.jacc.2014.07.012.

8. Шабаев И. Ф., Козырин К. А., Тарасов Р. С. Отдаленные результаты минимально инвазивного коронарного шунтирования на работающем сердце. Патология кровообращения и кардиохирургия. 2020;24(3):62-9. doi:10.21688/1681-3472-2020-3-62-69.

9. Warnes CA, Williams RG, Bashore TM, et al. ACC/AHA 2008 guidelines for the management of adults with congenital heart disease: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Writing Committee to Develop Guidelines on the Management of Adults With Congenital Heart Disease). Developed in Collaboration With the American Society of Echocardiography, Heart Rhythm Society, International Society for Adult Congenital Heart Disease, Society for Cardiovascular Angiography and Interventions, and Society of Thoracic Surgeons. J Am Coll Cardiol. 2008;52:143-263.

10. Serruys PW, Morice MC, Kappetein AP, et al. Percutaneous coronary intervention vs. coronary-artery bypass grafting for severe coronary artery disease. N Engl J Med. 2009;360(10):961-72.

11. Windecker S, Neumann FJ, Jüni P, et al. Considerations for the choice between coronary artery bypass grafting and percutaneous coronary intervention as revascularization strategies in major categories of patients with stable multivessel coronary artery disease: an accompanying article of the task force of the 2018 ESC/EACTS guidelines on myocardial revascularization. Eur Heart J. 2019;40(2):204-12. doi:10.1093/eurheartj/ehy532.

12. Leon MB, Smith CR, Mack M. Transcatheter aortic valve implantation for aortic stenosis in patients who cannot undergo surgery. N Engl J Med. 2010;363:1597-607.

13. Baumgartner H, Falk V, Bax JJ, et al. 2017 ESC/EACTS Guidelines for the management of valvular heart disease: the Task Force for the Management of Valvular Heart Disease of the European Society of Cardiology (ESC) and the European Association for CardioThoracic Surgery (EACTS). Eur Heart J. 2017;38:2739-86. doi:10.1093/eurheartj/ehx391.

14. Aboyans V, Ricco JB, Bartelink MEL, et al.; ESC Scientific Document Group. 2017 ESC Guidelines on the Diagnosis and Treatment of Peripheral Arterial Diseases, in collaboration with the European Society for Vascular Surgery (ESVS): Document covering atherosclerotic disease of extracranial carotid and vertebral, mesenteric, renal, upper and lower extremity arteriesEndorsed by: the European Stroke Organization (ESO). The Task Force for the Diagnosis and Treatment of Peripheral Arterial Diseases of the European Society of Cardiology (ESC) and of the European Society for Vascular Surgery (ESVS). Eur Heart J. 2018;39(9):763-816. doi:10.1093/eurheartj/ehx095.

15. Mariscalco G, Maselli D, Zanobini M, et al. Aortic centres should represent the standard of care for acute aortic syndrome. Eur J Prev Cardiol. 2018;25(1_suppl):3-14. doi:10.1177/2047487318764963.

16. 2019 Рекомендации ЕSC по диагностике и лечению хронического коронарного синдрома. Рабочая группа Европейского кардиологического общества по диагностике и лечению хронических коронарных синдромов. Российский кардиологический журнал. 2020;25(2):3757 doi:10.15829/1560-4071-2020-2-3757.

17. Ganyukov VI, Tarasov RS, Vereshchagin IE, Shukevich DL. Long-term outcome of highrisk percutaneous coronary interventions with extracorporeal membrane oxygenation support for patients without cardiogenic shock. Advances In Extra-Corporeal Perfusion Therapies. 2018:35-47.

18. Montalescot G, Bolognese L, Dudek D, et al., ACCOAST Investigators. Pretreatment with prasugrel in non-STsegment elevation acute coronary syndromes. N Engl J Med. 2013;369:999-1010.

19. Головина Т. С., Неверова Ю. Н., Тарасов Р. С. Сроки назначения двойной антитромбоцитарной терапии при остром коронарном синдроме: проблема доступности для пациентов коронарного шунтирования. Российский кардиологический журнал. 2020;25(8):3812. doi:10.15829/15604071-2020-3812.

20. Нишонов А. Б., Тарасов Р. С., Иванов С. В. и др. Результаты коронарного шунтирования у пациентов с острым коронарным синдромом без подъема сегмента ST высокого риска, выполненного в первые 24 часа. Патология кровообращения и кардиохирургия. 2020;24(2):73-82. doi:10.21688/1681-3472-2020-2-73-82.

21. Chang M, Lee CW, Ahn JM, et al. Comparison of outcome of coronary artery bypass grafting versus drug-eluting stent implantation for non-ST-elevation acute coronary syndrome. The American Journal of Cardiology. 2017;120(3):380-6. doi:10.1016/j.amjcard.2017.04.038.

22. Ramanathan K, Abel JG, Park JE, et al. Surgical Versus Percutaneous Coronary Revascularization in Patients With Diabetes and Acute Coronary Syndromes. J Am Coll Cardiol. 2017;70(24):2995-3006. doi:10.1016/j.jacc.2017.10.029.

23. Farkouh ME, Domanski M, Sleeper LA, et al. Strategies for multivessel revascularization in patients with diabetes. N Engl J Med. 2012;367:2375-84.

24. Ben-Gal Y, Mohr R, Feit F, et al. Surgical versus percutaneous coronary revascularization for multivessel disease in diabetic patients with non-ST-segment-elevation acute coronary syndrome: analysis from the Acute Catheterization and Early Intervention Triage Strategy trial. Circ Cardiovasc Interv. 2015;8(6):e002032. doi:10.1161/CIRCINTERVENTIONS.114.002032.

25. Farkouh ME, Domanski M, Dangas GD, et al.; FREEDOM Follow-On Study Investigators. Long-term survival following multivessel revascularization in patients with diabetes: the FREEDOM Follow-On Study. J Am Coll Cardiol. 2019;73:629-38. doi:10.1016/j.jacc.2018.11.001.

26. Head SJ, Davierwala PM, Serruys PW, et al. Coronary artery bypass grafting vs. percutaneous coronary intervention for patients with three-vessel disease: final five-year followup of the SYNTAX trial. Eur Heart J. 2014;35(40):2821-30. doi:10.1093/eurheartj/ehu213.

27. Schwalm JD, Wijeysundera HC, Tu JV, et al. Influence of coronary anatomy and SYNTAX score on the variations in revascularization strategies for patients with multivessel disease. Can J Cardiol. 2014;30(10):1155-61.

28. Эрлих А. Д. Изменения в лечении пациентов с острым коронарным синдромом без подъема сегмента ST в клинической практике за последние несколько лет (данные серии российских регистров РЕКОРД). Кардиология. 2018;58(12):13-21. doi:10.18087/cardio.2018.12.10189.

29. Thuijs DJ, Kappetein AP, Serruys PW, et al.; SYNTAX Extended Survival Investigators. Percutaneous coronary intervention versus coronary artery bypass grafting 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. Epub 2019 Sep 2. Erratum in: Lancet. 2020;395(10227):870.

30. Yan T, Padang R, Poh C, et al. Drug-eluting stents versus coronary artery bypass grafting for the treatment of coronary disease: Meta-analysis of randomized and nonrandomized studies. J Thorac Cardiovasc Surg. 2011;141(5):1134-44. doi:10.1016/j.jtcvs.2010.07.001.

31. Mohr FW, Morice MC, Kappetein AP, et al. Coronary artery bypass graft surgery vs. percutaneous coronary intervention in patients with three-vessel disease and left main coronary disease: 5-year follow-up of the randomised, clinical SYNTAX trial. Lancet. 2013;381(9867):629-38.

32. Ahn JM, Roh JH, Kim YH, et al. Randomized trial of stents versus bypass surgery for left main coronary artery disease: Five-year outcomes of the PRECOMBAT study. J Am Coll Cardiol. 2015;65(20):2198-206. doi:10.1016/j.jacc.2015.03.033.

33. Stone GW, Sabik JF, Serruys PW, et al. Everolimus-Eluting Stents or Bypass Surgery for Left Main Coronary Artery Disease. N Engl J Med. 2016;375(23):2223-35. doi:10.1056/NEJMoa1610227.

34. Head SJ, Milojevic M, Daemen J, et al. Mortality after coronary artery bypass grafting versus percutaneous coronary intervention with stenting for coronary artery disease: apooled analysis of individual patient data. Lancet. 2018;391:939-48. doi:10.1016/S01406736(18)30423-9.