TCTMD: Surgical Turndown Patients Need Better Risk Estimation Tools: OPTIMUM

Because real-world patients who are turned down for coronary artery bypass grafting (CABG) but end up undergoing percutaneous coronary intervention (PCI) with optimal medical therapy are complex and carry a high burden of comorbidity, they need better risk assessment than what is currently available, according to experts commenting on the now-published OPTIMUM results.

The most-telling reason for this, they argue, is because short-term mortality for these patients was substantially lower than what was projected by the evaluating surgeons even though currently available surgical risk models were reasonably accurate.

“There's this growing population who really their best option is probably not bypass surgery just because of prohibitive risk of the procedure,” lead author Adam C. Salisbury, MD, MSc (Saint Luke’s Mid America Heart Institute, Kansas City, Missouri), told TCTMD, adding that it’s been challenging to know even how to treat them with PCI. And they haven’t been well studied before now, he said. “Essentially, what we were going off of is institutional experience, personal experience, and limited studies from single centers.”

Read the full TCTMD article: Surgical Turndown Patients Need Better Risk Estimation Tools: OPTIMUM