{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,13]],"date-time":"2026-10-13T22:49:47Z","timestamp":1791931787929,"version":"4.3.4"},"reference-count":11,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2019,4,16]]},"abstract":"\n Background<\/jats:title>\n \n The Heart Team (\n HT<\/jats:styled-content>\n ) comprises integrated interdisciplinary decision making. Current guidelines assign a Class Ic recommendation for an\n HT<\/jats:styled-content>\n approach to complex coronary artery disease (\n CAD<\/jats:styled-content>\n ). However, there remains a paucity of data in regard to hard clinical end points. The aim was to determine characteristics and outcomes in patients with complex\n CAD<\/jats:styled-content>\n following\n HT<\/jats:styled-content>\n discussion.\n <\/jats:p>\n <\/jats:sec>\n \n Methods and Results<\/jats:title>\n \n This observational study was conducted at St Thomas\u2019 Hospital (London, UK). Case mixture included unprotected left main, 2\u2010vessel (including proximal left anterior descending artery)\n CAD<\/jats:styled-content>\n , 3\u2010vessel\n CAD<\/jats:styled-content>\n , or anatomical and\/or clinical equipoise.\n HT<\/jats:styled-content>\n strategy was defined as optimal medical therapy (\n OMT<\/jats:styled-content>\n ) alone,\n OMT<\/jats:styled-content>\n +percutaneous coronary intervention (\n PCI<\/jats:styled-content>\n ), or\n OMT<\/jats:styled-content>\n +coronary artery bypass grafting. From April 2012 to 2013, 51\n HT<\/jats:styled-content>\n meetings were held and 398 cases were discussed. Patients tended to have multivessel\n CAD<\/jats:styled-content>\n (74.1%), high SYNTAX (Synergy between PCI with Taxus and Cardiac Surgery) scores (median, 30; interquartile range, 23\u201339), and average age 69\u00b111\u00a0years. Multinomial logistic regression analysis performed to determine variables associated with\n HT<\/jats:styled-content>\n strategy demonstrated decreased likelihood of undergoing\n PCI<\/jats:styled-content>\n compared with\n OMT<\/jats:styled-content>\n in older patients with chronic kidney disease and peripheral vascular disease. The odds of undergoing coronary artery bypass grafting compared with\n OMT<\/jats:styled-content>\n decreased in the presence of cardiogenic shock and left ventricular dysfunction and increased in younger patients with 3\u2010vessel\n CAD<\/jats:styled-content>\n . Three\u2010year survival was 60.8% (84 of 137) in the\n OMT<\/jats:styled-content>\n cohort, 84.3% (107 of 127) in the\n OMT<\/jats:styled-content>\n +\n PCI<\/jats:styled-content>\n cohort, and 90.2% in the\n OMT<\/jats:styled-content>\n +coronary artery bypass grafting cohort (92 of 102).\n <\/jats:p>\n <\/jats:sec>\n \n Conclusions<\/jats:title>\n \n In our experience, the\n HT<\/jats:styled-content>\n approach involved a careful selection process resulting in appropriate patient\u2010specific decision making and good long\u2010term outcomes in patients with complex\n CAD<\/jats:styled-content>\n .\n <\/jats:p>\n <\/jats:sec>","DOI":"10.1161\/jaha.118.011279","type":"journal-article","created":{"date-parts":[[2019,4,4]],"date-time":"2019-04-04T09:03:29Z","timestamp":1554368609000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":47,"title":["Long\u2010Term Outcomes Following Heart Team Revascularization Recommendations in Complex Coronary Artery Disease"],"prefix":"10.1161","volume":"8","author":[{"given":"Tiffany","family":"Patterson","sequence":"first","affiliation":[{"name":"Division of Cardiovascular The Rayne Institute BHF Centre of Research Excellence King's College London St. Thomas\u2019 Hospital London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah Z.R.","family":"McConkey","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular The Rayne Institute BHF Centre of Research Excellence King's College London St. Thomas\u2019 Hospital London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fiyyaz","family":"Ahmed\u2010Jushuf","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Guy's and St Thomas\u2019 NHS Foundation Trust London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Moschonas","sequence":"additional","affiliation":[{"name":"Department of Cardiology King's College Hospital NHS Foundation Trust London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanna","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular The Rayne Institute BHF Centre of Research Excellence King's College London St. Thomas\u2019 Hospital London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Grigoris V.","family":"Karamasis","sequence":"additional","affiliation":[{"name":"Department of Cardiology Essex Cardiothoracic Centre Basildon United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Divaka","family":"Perera","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular The Rayne Institute BHF Centre of Research Excellence King's College London St. Thomas\u2019 Hospital London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brian R.","family":"Clapp","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Guy's and St Thomas\u2019 NHS Foundation Trust London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"James","family":"Roxburgh","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Guy's and St Thomas\u2019 NHS Foundation Trust London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Blauth","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Guy's and St Thomas\u2019 NHS Foundation Trust London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher P.","family":"Young","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Guy's and St Thomas\u2019 NHS Foundation Trust London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Simon R.","family":"Redwood","sequence":"additional","affiliation":[{"name":"Division of Cardiovascular The Rayne Institute BHF Centre of Research Excellence King's College London St. Thomas\u2019 Hospital London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Antonis N.","family":"Pavlidis","sequence":"additional","affiliation":[{"name":"Department of Cardiothoracic Guy's and St Thomas\u2019 NHS Foundation Trust London United Kingdom"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_1_2_2","doi-asserted-by":"publisher","DOI":"10.1002\/ccd.24701"},{"key":"e_1_3_1_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jacc.2011.08.007"},{"key":"e_1_3_1_4_2","doi-asserted-by":"publisher","DOI":"10.1056\/NEJMoa0804626"},{"key":"e_1_3_1_5_2","doi-asserted-by":"publisher","DOI":"10.1161\/01.CIR.101.24.2795"},{"key":"e_1_3_1_6_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.112.966101"},{"key":"e_1_3_1_7_2","doi-asserted-by":"publisher","DOI":"10.1161\/CIRCOUTCOMES.113.000269"},{"key":"e_1_3_1_8_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijcard.2016.01.041"},{"key":"e_1_3_1_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2009.10.017"},{"key":"e_1_3_1_10_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(11)60775-7"},{"key":"e_1_3_1_11_2","doi-asserted-by":"publisher","DOI":"10.1093\/eurheartj\/ehs184"},{"key":"e_1_3_1_12_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcin.2010.06.016"}],"container-title":["Journal of the American Heart Association"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.ahajournals.org\/doi\/full\/10.1161\/JAHA.118.011279","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,5,13]],"date-time":"2024-05-13T11:06:41Z","timestamp":1715598401000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ahajournals.org\/doi\/10.1161\/JAHA.118.011279"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2019,4,16]]},"references-count":11,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2019,4,16]]}},"alternative-id":["10.1161\/JAHA.118.011279"],"URL":"https:\/\/doi.org\/10.1161\/jaha.118.011279","relation":{},"ISSN":["2047-9980"],"issn-type":[{"value":"2047-9980","type":"electronic"}],"subject":[],"published":{"date-parts":[[2019,4,16]]},"assertion":[{"value":"2018-11-12","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-02-07","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2019-04-04","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e011279"}}