In May 2026, the American Heart Association (AHA) formally released the scientific statement "Secondary Prevention After Coronary Artery Bypass Graft Surgery: 2026 Update", which updates the 2015 statement. The new statement emphasizes a patient-centered shared decision-making model and further clarifies the application status of several novel drugs, including proprotein convertase subtilisin/kexin type 9 inhibitors (PCSK9i), sodium-glucose cotransporter 2 inhibitors (SGLT2i), glucagon-like peptide-1 receptor agonists (GLP-1a), and angiotensin receptor-neprilysin inhibitors (ARNIs), in coronary artery bypass grafting (CABG) patients with relevant indications. This article systematically summarizes and interprets the major recommendations of the statement. In conjunction with the current status of postoperative management after CABG in China, it discusses the potential applicability, implementation barriers, and future research directions of these recommendations, with the aim of providing practical guidance for cardiac surgeons and other clinicians involved in the long-term management of patients after CABG.
Extrahepatic metastasis in hepatocellular carcinoma indicates that the disease has progressed from a liver-confined lesion to an advanced systemic stage, representing an important clinical condition that influences therapeutic decision-making and patient prognosis. These patients are often characterized by a complex background of chronic liver disease, impaired hepatic functional reserve, variable intrahepatic primary tumor burden, and substantial heterogeneity in the site, extent, and burden of extrahepatic metastases, resulting in marked variability in disease status and therapeutic needs and substantial complexity in clinical decision-making. In recent years, with the rapid development of systemic therapies for advanced hepatocellular carcinoma and the continuous refinement of local and locoregional approaches, including surgery, interventional therapy, ablation, and radiotherapy, the treatment paradigm for this population has gradually shifted from single-discipline decision-making to comprehensive multidisciplinary management. In clinical practice, the management of patients with hepatocellular carcinoma and extrahepatic metastases requires not only evaluation of intrahepatic tumor status, hepatic functional reserve, and the underlying liver disease, but also assessment of the location, extent, symptom burden, and risk of organ dysfunction related to extrahepatic lesions. These factors should be integrated with the patient’s general condition and tolerance to subsequent treatment in order to formulate a stage-specific and goal-directed management strategy. The Chinese Expert Consensus on the Multidisciplinary Diagnosis and Management of Hepatocellular Carcinoma with Extrahepatic Metastases（2026 Edition) systematically addresses key issues including multidisciplinary collaborative assessment and decision-making pathways, imaging evaluation, systemic therapy, and the integration of local treatment. It also provides organ-specific recommendations based on the clinical characteristics of metastases involving the lung, bone, lymph nodes, adrenal glands, peritoneum, and brain, with the aim of providing a reference for standardized multidisciplinary management of patients with hepatocellular carcinoma and extrahepatic metastases.
