2021 ACC/AHA/SCAI Guideline for Coronary Artery Revascularization: A Report of the American College of Cardiology/American Heart Association Joint Committee on Clinical Practice Guidelines

J Am Coll Cardiol. 2022 Jan 18;79(2):e21-e129. doi: 10.1016/j.jacc.2021.09.006. Epub 2021 Dec 9.


Aim: The guideline for coronary artery revascularization replaces the 2011 coronary artery bypass graft surgery and the 2011 and 2015 percutaneous coronary intervention guidelines, providing a patient-centric approach to guide clinicians in the treatment of patients with significant coronary artery disease undergoing coronary revascularization as well as the supporting documentation to encourage their use.

Methods: A comprehensive literature search was conducted from May 2019 to September 2019, encompassing studies, reviews, and other evidence conducted on human subjects that were published in English from PubMed, EMBASE, the Cochrane Collaboration, CINHL Complete, and other relevant databases. Additional relevant studies, published through May 2021, were also considered.

Structure: Coronary artery disease remains a leading cause of morbidity and mortality globally. Coronary revascularization is an important therapeutic option when managing patients with coronary artery disease. The 2021 coronary artery revascularization guideline provides recommendations based on contemporary evidence for the treatment of these patients. The recommendations present an evidence-based approach to managing patients with coronary artery disease who are being considered for coronary revascularization, with the intent to improve quality of care and align with patients' interests.

Keywords: ACC/AHA Clinical Practice Guidelines; angiogram; angiography; angioplasty; arterial graft; cardiac surgery; coronary artery bypass graft surgery; coronary atherosclerosis; internal mammary artery graft; internal thoracic artery graft; left ventricular dysfunction; multivessel PCI; myocardial infarction; myocardial revascularization; non–ST-segment–elevated myocardial infarction; percutaneous coronary intervention; percutaneous transluminal coronary angioplasty; post-bypass; saphenous vein graft; stent(s); vein graft lesions.

Publication types

  • Practice Guideline
  • Systematic Review

MeSH terms

  • American Heart Association
  • Cardiology / standards*
  • Coronary Artery Disease / therapy*
  • Humans
  • Myocardial Revascularization / methods
  • Myocardial Revascularization / standards*
  • United States