Presentatie - vzw farmaka asbl

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- Terminologie invasieve ingrepen - • PTCA= Percutaneous Transluminal Coronary Angioplasty = term voor het verbreden van een vernauwing dmv ballonnetje = “balloon angioplasty” Stent al dan niet na PTCA • PCI= Percutaneous Coronary Intervention = term voor het geheel van percutane coronaire interventies (PTCA zonder stent, PTCA met stent, verschillende soorten stents) • CABG= Coronary Artery Bypass Grafting • Bare Metal Stent (BMS) • Drug Eluting Stent (DES) Met sirolimus (immunosuppressivum) of paclitaxel (antitumoraal) www.<strong>farmaka</strong>.be Project Farmaka
4b.Bates. EBM 2001;6:13. Commentary on: Bucher. BMJ 2000;321:73-7 Design N/n Population Sd Interventions Outcomes Results MA N=6, n=1904 -PTCA -Medication only Angina at the end of study -Stable angina pectoris -59%: history of acute myocardial infarction (MI) -No acute MI in previous week -3 RCTs: patients without symptomatic angina -Stents in a minority of patients only in 1 study 6 to 57 m PTCA vs enkel medicatie -53% (PTCA) vs 70% -RRR= 30% (95%CI 2 to 50) -NNT= 6 (95%CI 3 to 637) Mortality -15 deaths (PTCA) vs 11 -RR= 1.32 (95%CI 0.65 to 2.70) in favour of medication Non-fatal MI -41 MI’s (PTCA) vs 29 -RR=1.42 (95%CI 0.9 to 2.25) CABG (Coronary -7.6% (PTCA) vs 4.1% Artery Bypass -RRI= 59% (95%CI 9 to 132) Grafting) -NNH= 29 (95%CI 19 to 66) Need for PTCA -RR=1.29 (95%CI 0.71 to 3.36) - 52.Boden. COURAGE trial. NEJM 2007;356:1503-16 - Schröder. De plaats van coronaire angioplastiek bij stabiele angor. Minerva 2007;6(10):152-3 (NL). Minerva 2008;7(1):2-3 (FR). Commentary on Boden. NEJM 2007;356:1503-16 Design n Population Sd Interventions Outcomes Results RCT 2287 -Coronary artery disease (with or without angina symptoms) 5y -PTCA (+/- stent, usually bare-metal) + medication -Medication only (92% statins; 84% β-blocker; 72% ACE-I or sartans) Primary outcome Mortality OR Nonfatal MI -19% (PTCA) vs 18.5% -RR= 1.05 (95%CI 0.87 to 1.27) -Mortality: 1.7% in both groups Secondary outcomes Mortality, MI, stroke -RR=1.05 (95%CI 0.87 to 1.27) Hospitalisation for -RR= 1.07 (95%CI 0.84 to 1.37) unstable angina www.<strong>farmaka</strong>.be Project Farmaka
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Projekt Farmaka vzw Centrum voor on
Page 3 and 4:
Hoe? 1. Van een klinisch probleem n
Page 5 and 6: Aanpak van stabiele angor www.farma
Page 7 and 8: Definitie en epidemiologie www.farm
Page 9 and 10: Natuurlijk verloop www.farmaka.be P
Page 11 and 12: Doelstelling van de behandeling www
Page 13 and 14: Acute behandeling www.farmaka.be Pr
Page 15 and 16: Anti-anginosa (onderhoudsbehandelin
Page 17 and 18: ANTIANGINOSA (niet in België) - we
Page 19 and 20: β-blokkers Niet-selectieve β-blok
Page 21: NITRATEN Sublinguaal Posologie Isos
Page 24 and 25: β-blokkers 17.Pepine. The atenolol
Page 26 and 27: β-blokkers Preserved ventricular f
Page 28 and 29: β-blokkers Helfand 2007 www.farmak
Page 30 and 31: - β-blokkers - • Mortaliteit en
Page 32 and 33: Calcium-antagonisten Gami P. Second
Page 34 and 35: • Werkzaam op angor - Calciumanta
Page 36 and 37: Nitraten 25.Heidenreich. JAMA 1999;
Page 38 and 39: - Molsidomine - • Werkzaamheid op
Page 40 and 41: - Trimetazidine, ranolazine, nicora
Page 42 and 43: - Combinaties en werkzaamheid angor
Page 44 and 45: Anti-anginosa - ongewenste effecten
Page 50 and 51: Invasieve behandeling www.farmaka.b
Page 52 and 53: - Aanvullende medicatie bij PCI -
Page 54 and 55: www.farmaka.be Project Farmaka
Page 58 and 59: PTCA vs enkel medicatie 53.Borzak.
Page 60 and 61: - PTCA vs enkel medicatie - • Bej
Page 62 and 63: - CABG vs enkel medicatie - • ↓
Page 64: -Stents - Bedoeling stents en DES:
Page 67 and 68: - CABG vs PTCA - • CABG: meer CVA
Page 69 and 70: Onderhoudsbehandeling Globale CV pr
Page 71 and 72: Rookstop Gami P. Secondary preventi
Page 73 and 74: Mediterraan dieet 1.Gami P. Seconda
Page 75 and 76: Oefentherapie 77. Gami P. Secondary
Page 77 and 78: - Oefentherapie - • Vs “usual t
Page 79 and 80: - Stressmanagement - • Mogelijk
Page 81 and 82: - β-blokkers - Zie hoger www.farma
Page 83 and 84: Anti-aggregantia - ASA Gami P. Seco
Page 85 and 86: Consensusvergadering angor 2006. Di
Page 87 and 88: Anti-aggregantia - Ticlopidine en
Page 89 and 90: ACE-inhibitoren • Bij hoogrisicop
Page 91 and 92: - Sartanen - • Ramipril vs telmis
Page 93 and 94: -Statines - • ↓ mortaliteit en
Page 95 and 96: - Kernboodschappen - Patiënt met s
Page 97 and 98: - Symptomatische behandeling - •
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Presentatie - vzw farmaka asbl

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