RESUMO
The joint European Society of Cardiology and European Association of Cardio-Thoracic Surgery (ESC/EACTS) guidelines on myocardial revascularization collect and summarize the evidence regarding decision-making, diagnostics, and therapeutics in various clinical scenarios of coronary artery disease, including elective, urgent, and emergency settings. The 2014 document updates and extends the effort started in 2010, year of the first edition of these guidelines. Importantly, this latest edition provides a systematic review of all randomized clinical trials performed since 1980, comparing different strategies of myocardial revascularization, including coronary artery bypass graft (CABG), balloon angioplasty, percutaneous coronary intervention (PCI) with bare-metal stents (BMS) and first- and second-generation drug-eluting stents (DES). This review aims to highlight the most relevant novelties introduced by the 2014 edition of the ESC/EACTS myocardial revascularization guidelines as compared with the previous edition and to describe similarities and differences with the American societies' guidelines.
Assuntos
Ponte de Artéria Coronária/normas , Doença da Artéria Coronariana/terapia , Estenose Coronária/terapia , Intervenção Coronária Percutânea/normas , Consenso , Ponte de Artéria Coronária/efeitos adversos , Ponte de Artéria Coronária/história , Ponte de Artéria Coronária/mortalidade , Doença da Artéria Coronariana/diagnóstico , Doença da Artéria Coronariana/história , Doença da Artéria Coronariana/mortalidade , Estenose Coronária/diagnóstico , Estenose Coronária/história , Estenose Coronária/mortalidade , Medicina Baseada em Evidências , História do Século XX , História do Século XXI , Humanos , Intervenção Coronária Percutânea/efeitos adversos , Intervenção Coronária Percutânea/história , Intervenção Coronária Percutânea/instrumentação , Intervenção Coronária Percutânea/mortalidade , Ensaios Clínicos Controlados Aleatórios como Assunto , Índice de Gravidade de Doença , Stents , Fatores de Tempo , Resultado do TratamentoAssuntos
Doença da Artéria Coronariana/história , Estenose Coronária/história , Pessoas Famosas , Ruptura Cardíaca Pós-Infarto/história , Música , Infarto do Miocárdio/história , Angina Pectoris/história , Doença da Artéria Coronariana/terapia , Estenose Coronária/terapia , Europa (Continente) , Alemanha , História do Século XIX , HumanosRESUMO
BACKGROUND: Atherosclerotic cardiovascular disease is often thought of as a disease of modernity, a disease affecting primarily men and a disease primarily affecting members of affluent Western societies. METHODS: We reviewed CT scans for evidence of vascular calcification as a manifestation of atherosclerosis in ancient Egyptian female mummies and compared the results to clinical features of contemporary Egyptian women, who are suffering from an epidemic of atherosclerotic cardiovascular disease. RESULTS: The common assumption that atherosclerosis is strictly a modern disease which spares women, mainly affecting men, is not true. We report the CT examination of an ancient Egyptian woman who lived more than 3000 years ago, finding calcified atherosclerotic plaque in her systemic arteries and other abnormalities probably due to prior myocardial infarction. We also confirmed recent reports of a virtual epidemic of atherosclerotic cardiovascular disease in contemporary Egyptian women. CONCLUSIONS: Atherosclerosis, both ancient and contemporary, is common in women as well as in men, and is related to both a genetic predisposition and to environmental factors including diet, exercise, obesity and exposure to smoke and other toxins.