Presentatie - vzw farmaka asbl

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- PTCA vs enkel medicatie - • Bejaarden: TIME studie – Op lange termijn geen verschil voor angor en mortaliteit – Enkel medicatie: groot risico van latere hospitalisatie Afweging tussen • Initiële invasieve strategie met operatief risico • Optimale medicamenteuze strategie met risico van latere hospitalisatie met of zonder revascularisatie interventie www.<strong>farmaka</strong>.be Project Farmaka
CABG vs enkel medicatie Gami P. Secondary prevention of ischaemic cardiac events. Clinical Evidence 2007. Design N/n Population Interventions Outcomes Results SR N=7, -Coronary artery disease -CABG Death -RR=0.61 in favour of CABG n=2649 -Mostly male -Medication at 5 years (95%CI 0.48 to 0.77) -41-60 y only Death -RR= 0.83 in favour of CABG -80% ventricular ejection fraction > 50% at 10 years (95%CI 0.70 to 0.98) -60% prior MI -83% with 2 or 3 vessel disease Death or MI -11.6% (CABG) vs 8% at 1 year -RR=1.45 (95%CI 1.18 to 2.03) The results of the systematic review may not be easily generalised to current practice. People were aged 65 years or younger, but more than 50% of CABG procedures are now performed on people over 65 years of age. In addition, almost all were male and high risk people, such as those with severe angina and left main coronary artery stenosis, were under-represented. Internal thoracic artery grafts were used in fewer than 5% of people. Lipid lowering agents (particularly statins) and aspirin were used infrequently (aspirin used in 3% of people at enrolment). Only about 50% of people were taking beta-blockers. The systematic review may underestimate the real benefits of CABG in comparison with medical treatment alone because medical and surgical treatment for coronary artery disease were not mutually exclusive; by 5 years, 25% of people receiving medical treatment had undergone CABG surgery and by 10 years, 41% had undergone CABG surgery. The underestimate of effect would be greatest among people at high risk. People with previous CABG have not been studied in RCTs, although they now represent a growing proportion of those undergoing CABG. www.<strong>farmaka</strong>.be Project Farmaka
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Projekt Farmaka vzw Centrum voor on
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Hoe? 1. Van een klinisch probleem n
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Aanpak van stabiele angor www.farma
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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
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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
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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;
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Page 42 and 43: - Combinaties en werkzaamheid angor
Page 44 and 45: Anti-anginosa - ongewenste effecten
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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
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Page 81 and 82: - β-blokkers - Zie hoger www.farma
Page 83 and 84: Anti-aggregantia - ASA Gami P. Seco
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