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<p>The national treatment guidelines provide recommendations for the diagnostics and treatment based on current, representative and methodologically high-quality studies, they are intended to reflect the clinical reality in Germany and provide patient-centered recommendations; however, the current national guidelines for chronic coronary artery disease (NVL-CCS) do only insufficiently meet these requirements. Contradictory to scientific evidence and European guidelines, the NVL-CCS recommend the inaccurate Marburg heart score to assess the probability of obstructive coronary artery disease and a&#xa0;fixed-dose strategy for cholesterol-lowering statin treatment. The prognostic benefits of myocardial revascularization are denied and the recommendations for selecting the modality of myocardial revascularization in complex coronary artery disease are based on an uncritical and potentially biased interpretation of the available evidence. The decision aids for patients who require invasive coronary angiography or myocardial revascularization are neither evidence-based nor practical and often appear confusing. Against this background, the German Cardiac Society (DGK) and the German Society for Internal Medicine (DGIM) have decided not to consent to the NVL‑CCS and recommend a revision of the guidelines. The German Society for Prevention and Rehabilitation of Cardiovascular Diseases (DGPR) concurs with the content of the statement.</p>

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Stellungnahme zur kritischen Bewertung der Nationalen VersorgungsLeitlinie zur chronischen koronaren Herzerkrankung

  • 期刊论文

  • 发表日期：

    2025年3月25日

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  • Julinda Mehilli,
  • Lars Eckardt,
  • Ulrich Laufs,
  • Jana Boer,
  • Ralf Birkemeyer,
  • Stephan Frantz,
  • Volker Schächinger,
  • Felix Mahfoud,
  • Christian Perings,
  • Alexander Ghanem,
  • Axel Linke,
  • Dirk Westermann,
  • Georg Ertl,
  • Bernd Nowak,
  • Norbert Henke,
  • Eike Langheim,
  • Holger Thiele

摘要

The national treatment guidelines provide recommendations for the diagnostics and treatment based on current, representative and methodologically high-quality studies, they are intended to reflect the clinical reality in Germany and provide patient-centered recommendations; however, the current national guidelines for chronic coronary artery disease (NVL-CCS) do only insufficiently meet these requirements. Contradictory to scientific evidence and European guidelines, the NVL-CCS recommend the inaccurate Marburg heart score to assess the probability of obstructive coronary artery disease and a fixed-dose strategy for cholesterol-lowering statin treatment. The prognostic benefits of myocardial revascularization are denied and the recommendations for selecting the modality of myocardial revascularization in complex coronary artery disease are based on an uncritical and potentially biased interpretation of the available evidence. The decision aids for patients who require invasive coronary angiography or myocardial revascularization are neither evidence-based nor practical and often appear confusing. Against this background, the German Cardiac Society (DGK) and the German Society for Internal Medicine (DGIM) have decided not to consent to the NVL‑CCS and recommend a revision of the guidelines. The German Society for Prevention and Rehabilitation of Cardiovascular Diseases (DGPR) concurs with the content of the statement.