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Lawton et al 2021 ACC/AHA/SCAI Coronary Revascularization Guideline January 18, 2022 Circulation. 2022;145:e18–e114. DOI: 10.1161/CIR.0000000000001038 e80 CLINICAL STATEMENTS AND GUIDELINES the RCT of revascularization before vascular surgery did not report improved outcomes with PCI.53 Nonetheless, because of the increased risk of cardiovascular events among renal transplant recipients,54 routine risk assessment is often performed before consideration for transplantation. When obstructive CAD is noted, many transplantation surgeons are hesitant to proceed with surgery in this complex group of patients without revascularization; therefore, it is common for a patient to be referred for revascularization in preparation for organ transplantation. In the Ischemia CKD trial, there were no differences in outcomes with routine revascularization even in the presence of severe ischemia, although only about 10% of enrolled patients were on the waitlist for transplantation. Even less is known about revascularization before liver transplantation. For this reason, it remains unclear whether revascularization before organ transplantation imparts a better outcome, and RCTs are needed to further inform care in this complex group of patients. ACC/AHA JOINT COMMITTEE MEMBERS Patrick T. O’Gara, MD, MACC, FAHA, Chair; Joshua A. Beckman, MD, MS, FAHA, FACC, Chair-Elect; Glenn N. Levine, MD, FACC, FAHA, Immediate Past Chair*; Sana M. Al-Khatib, MD, MHS, FACC, FAHA*; Anastasia L. Armbruster, PharmD, FACC; Kim K. Birtcher, PharmD, MS, AACC*; Joaquin E. Cigarroa, MD, FACC*; Lisa de las Fuentes, MD, MS, FAHA; Anita Deswal, MD, MPH, FACC, FAHA; Dave L. Dixon, PharmD, FACC*; Lee A. Fleisher, MD, FACC, FAHA*; Federico Gentile, MD, FACC*; Zachary D. Goldberger, MD, FACC, FAHA*; Bulent Gorenek, MD, FACC; Norrisa Haynes, MD, MPH; Adrian F. Hernandez, MD, MHS; Mark A. Hlatky, MD, FACC, FAHA*; José A. Joglar, MD, FACC, FAHA; W. Schuyler Jones, MD, FACC; Joseph E. Marine, MD, FACC*; Daniel B. Mark, MD, MPH, FACC, FAHA; Debabrata Mukherjee, MD, FACC, FAHA, FSCAI; Latha P. Palaniappan, MD, MS, FACC, FAHA; Mariann R. Piano, RN, PhD, FAHA; Tanveer Rab, MD, FACC; Erica S. Spatz, MD, MS, FACC; Jacqueline E. Tamis-Holland, MD, FAHA, FACC, FSCAI; Duminda N. Wijeysundera, MD, PhD*; Y. Joseph Woo, MD, FACC, FAHA PRESIDENTS AND STAFF American College of Cardiology Dipti N. Itchhaporia, MD, FACC, President Cathleen C. Gates, Chief Executive Officer MaryAnne Elma, MPH, Senior Director, Enterprise Content and Digital Strategy Grace D. Ronan, Team Leader, Clinical Policy Publications Timothy W. Schutt, MA, Clinical Practice Guidelines Analyst American College of Cardiology/American Heart Association Thomas S.D. Getchius, Director, Guideline Strategy and Operations Abdul R. Abdullah, MD, Director, Guideline Science and Methodology American Heart Association Mitchell S.V. Elkind, MD, MS, FAAN, FAHA, President Nancy Brown, Chief Executive Officer Mariell Jessup, MD, FAHA, Chief Science and Medical Officer Radhika Rajgopal Singh, PhD, Senior Vice President, Office of Science and Medicine Johanna A. Sharp, MSN, RN, Science and Medicine Advisor, Office of Science, Medicine and Health Jody Hundley, Production and Operations Manager, Scientific Publications, Office of Science Operations ARTICLE INFORMATION This document was approved by the American College of Cardiology Clinical Policy Approval Committee, the American Heart Association Science Advisory and Coordinating Committee, the American College of Cardiology Science and Quality Committee, the American Heart Association Executive Committee, and the Society for Cardiovascular Angiography and Interventions Executive Committee in August 2021. The Comprehensive RWI Data Supplement table is available with this article at http://circ.ahajournals.org/lookup/suppl/doi:10.1161/CIR.0000000000001038. This article has been copublished in the Journal of the American College of Cardiology. Copies: This document is available on the websites of the American Heart Association (professional.heart.org) and the American College of Cardiology (www.acc.org). A copy of the document is also available at https://professional. heart.org/statements by selecting the “Guidelines & Statements” button. To purchase additional reprints, call 215-356-2721 or email Meredith.Edelman@ wolterskluwer.com. The expert peer review of AHA-commissioned documents (eg, scientific statements, clinical practice guidelines, systematic reviews) is conducted by the AHA Office of Science Operations. For more on AHA statements and guidelines development, visit https://professional.heart.org/statements. Select the “Guidelines & Statements” drop-down menu near the top of the webpage, then click “Publication Development.” Permissions: Multiple copies, modification, alteration, enhancement, and/or distribution of this document are not permitted without the express permission of the American Heart Association. Instructions for obtaining permission are located at https://www.heart.org/permissions. A link to the “Copyright Permissions Request Form” appears in the second paragraph (https://www.heart.org/ en/aboutus/statements-and-policies/copyright-request-form). REFERENCES PREAMBLE 1 Committee on Standards for Developing Trustworthy Clinical Practice Guidelines, Institute of Medicine (US). Clinical Practice Guidelines We Can Trust. National Academies Press; 2011. 2. Committee on Standards for Systematic Reviews of Comparative Effectiveness Research, Institute of Medicine (US). Finding What Works in Health Care: Standards for Systematic Reviews. National Academies Press; 2011. 3. Anderson JL, Heidenreich PA, Barnett PG, et al. ACC/AHA statement on cost/value methodology in clinical practice guidelines and performance measures: a report of the American College of Cardiology/American Heart Association Task Force on Performance Measures and Task Force on Practice Guidelines. Circulation. 2014;129:2329–2345. *Former Joint Committee member; current member during the writing effort. Downloaded from http://ahajournals.org by on October 7, 2026