Professionals

There is more and more evidence of the superiority of medical therapy over stenting, not only with coronary artery disease, but also with stenotic arteries in your brain: The 30-day rate of stroke or death associated with stenting (14.7%) is nearly 2.5 times as high as the 6% rate associated with stenting in high-risk patients with a 70 - 90 % severe intracranial arterial stenosis.

Comment:

The original EuroSCORE has been replaced with a new model, EuroSCORE II, announced at the EACTS meeting in Lisbon on Monday on 10/3/2011. In this new version, an additional risk factor "Poor mobility" has been added, while others, such as "Obesity" were omitted.

As is well known, although restriction of diet often results in initial weight loss, more than 80 per cent of obese dieters fail to maintain their reduced weight.

A new study from Australia involved 50 overweight or obese patients without diabetes in a 10-week weight-loss program using a very-low-energy diet. Levels of appetite-regulating hormones were measured at baseline, at the end of the program and one year after initial weight loss.

• Diagnosis of hypertension
• Blood Pressure Goals
• Recommendations for evaluation
  • Treatable causes
  • End-organ damage
  • Cardiovascular risks
  • Barriers to treatment
• Recommendations for management
  • Nonpharmalogical measures
  • Pharmacological measures
    • Thiazides
    • Angiotensin receptor blockers (ARBs)
    • Angiotensin converting enzyme (ACE) inhibitors
    • Non-thiazide diuretics
    • Beta blockers
    • Alpha blockers
    • Calcium channel blockers
    • Direct renin inhibitors
    • Non-specific vasodilators
    • Selected combination regimens
    • Adjust regimens

In this study, the authors analyzed the combined results of four different randomized clinical trials, comparing PCI with CABG in the treatment of Left Main CAD.

Comparing MACCE (major adverse cardiac or cerebrovascular events) they found “nonsignificantly different 1-year rates of MACCE” between the two treatment modalities after 12 months (14.5% vs. 11.8%, P value 0.11).

The studies included were:

As we have reported repeatedly in previews of the SYNTAX trial, the rate of CABG surgeries declined by approximately one-third and that of PCI procedures fell by 4% between 2001 and 2008, according to another study published in JAMA in May, 2011.

Each year, more than 2 million Americans have a heart attack or stroke, of whom more than 800,000 of them die; cardiovascular disease is the leading cause of death in the United States and the largest cause of lower life expectancy among blacks.