Koroner Arter Hastalığı Poliklinik Takibi

Koroner arter hastalığı kalp hastalıkları içinde en yaygın gözlenen formdur. Tüm dünyada erkeklerde ve kadınlarda başlıca ölüm nedenidir. Koroner arter hastalığı kalp kasının ihtiyacı olan kan deste- ğinin koroner damarların sertleşmesi ve daralması sonucunda gelişir. Sıklıkla kolesterol plakları buna neden olur. Koroner arterler daraldığı zaman daha az kan geçişi söz konusu olur ve bu da angina pektoris denilen göğüs ağrısına veya miyokard infarktüsüne yol açar. Koroner arter hastalığı tedavisinin amacı semptomları kontrol etmek ve hastalığın progresyonunu yavaşlatmak veya durdurmaktır. Tedavinin metodu semptomlar, fizik muayene ve tanısal testlerle belirlenen birçok faktöre bağlıdır.

Coronary Artery Disease Management in Polyclinic

Coronary artery disease (CAD) is the most common type of heart disease. It is the leading cause of death in the world in both men and women. Coronary artery disease happens when the arteries that supply blood to heart muscle become hardened and narrowed. This is due to the build up of cholesterol and other material, called plaque on their inner walls. As the build up grows, less blood can flow through the arteries. As a result heart muscle can't get the blood or oxygen it needs. This can lead to chest pain (angina) or a heart attack. Treatment of CAD is aimed at controlling symptoms and slowing or stopping the progression of disease. The method of treatment is based on many factors determined by symptoms, a physical exam, and diagnostic testing. Koroner arter hastalığı kalp hastalıkları içinde en yaygın gözlenen formdur. Tüm dünyada erkeklerde ve kadınlarda başlıca ölüm nedenidir. Koroner arter hastalığı kalp kasının ihtiyacı olan kan desteğinin koroner damarların sertleşmesi ve daralması sonucunda gelişir. Sıklıkla kolesterol plakları buna neden olur. Koroner arterler daraldığı zaman daha az kan geçişi söz konusu olur ve bu da angina pektoris denilen göğüs ağrısına veya miyokard infarktüsüne yol açar. Koroner arter hastalığı tedavisinin amacı semptomları kontrol etmek ve hastalığın progresyonunu yavaşlatmak veya durdurmaktır. Tedavinin metodu semptomlar, fizik muayene ve tanısal testlerle belirlenen birçok faktöre bağlıdır.

___

  • Murray CJL, Lopez AD, editors. The global burden of disea- se. Cambridge, MA: Harvard School of Public Health; 1996.
  • Omran AR. The epidemiologic transition. A theory of the epidemiology of population change. Milbank Mem Fund Q 1971;49:509-38.
  • Kannel WB, Feinleib M. Natural history of angina pectoris in the Framingham study. Prognosis and survival. Am J Cardiol 1972;29:154-63.
  • Murabito JM, Evans JC, Larson MG, Levy D. Prognosis after the onset of coronary heart disease. An investigation of dif- ferences in outcome between the sexes according to initial coronary disease presentation. Circulation 1993;88:2548-55.
  • Pepine CJ, Handberg EM, Cooper-DeHoff RM, Marks RG, Kowey P, Messerli FH, et al. A calcium antagonist vs a non-calcium antagonist hypertension treatment strategy for patients with coronary artery disease. The International Verapamil-Trandolapril Study (INVEST): a randomized controlled trial. JAMA 2003;290:2805-16.
  • Dargie HJ, Ford I, Fox KM. Total Ischaemic Burden European Trial (TIBET). Effects of ischaemia and treatment with atenolol, nifedipine SR and their combination on outcome in patients with chronic stable angina. The TIBET Study Group. Eur Heart J 1996;17:104-12.
  • Malik S, Wong ND, Franklin SS, Kamath TV, L'Italien GJ, Pio JR, et al. Impact of the metabolic syndrome on mortality from coronary heart disease, cardiovascular disease, and all causes in United States adults. Circulation 2004;110:1245-50.
  • Girman CJ, Rhodes T, Mercuri M, Pyörälä K, Kjekshus J, Pedersen TR, et al. The metabolic syndrome and risk of major coronary events in the Scandinavian Simvastatin Survival Study (4S) and the Air Force/Texas Coronary Atherosclerosis Prevention Study (AFCAPS/TexCAPS). Am J Cardiol 2004;93:136-41.
  • Horne BD, Anderson JL, John JM, Weaver A, Bair TL, Jensen KR, et al. Which white blood cell subtypes predict increased cardiovascular risk? J Am Coll Cardiol 2005;45:1638-43.
  • Hung J, Chaitman BR, Lam J, Lesperance J, Dupras G, Fines P, et al. Noninvasive diagnostic test choices for the evalu- ation of coronary artery disease in women: a multivariate comparison of cardiac fluoroscopy, exercise electrocardiog- raphy and exercise thallium myocardial perfusion scintig- raphy. J Am Coll Cardiol 1984;4:8-16.
  • Gibbons RJ, Chatterjee K, Daley J, Douglas JS, Fihn SD, Gardin JM, et al. ACC/AHA/ACP-ASIM guidelines for the management of patients with chronic stable angina: a report of the American College of Cardiology/American Heart Association Task Force on Practice Guidelines (Committee on Management of Patients With Chronic Stable Angina). J Am Coll Cardiol 1999;33:2092-197.
  • Schinkel AF, Bax JJ, Geleijnse ML, Boersma E, Elhendy A, Roelandt JR, et al. Noninvasive evaluation of ischaemic heart disease: myocardial perfusion imaging or stress echo- cardiography? Eur Heart J 2003;24:789-800.
  • Noto TJ Jr, Johnson LW, Krone R, Weaver WF, Clark DA, Kramer JR Jr, et al. Cardiac catheterization 1990: a report of the Registry of the Society for Cardiac Angiography and Interventions (SCA&I). Cathet Cardiovasc Diagn 1991;24:75-83.
  • Mark DB, Hlatky MA, Harrell FE Jr, Lee KL, Califf RM, Pryor DB. Exercise treadmill score for predicting prognosis in coro- nary artery disease. Ann Intern Med 1987;106:793-800.
  • Geleijnse ML, Elhendy A, van Domburg RT, Cornel JH, Rambaldi R, Salustri A, et al. Cardiac imaging for risk strati- fication with dobutamine-atropine stress testing in patients with chest pain. Echocardiography, perfusion scintigraphy, or both? Circulation 1997;96:137-47.
  • Olmos LI, Dakik H, Gordon R, Dunn JK, Verani MS, Quiñones MA, et al. Long-term prognostic value of exercise echocardiography compared with exercise 201Tl, ECG, and clinical variables in patients evaluated for coronary artery disease. Circulation 1998;98:2679-86.
  • Hachamovitch R, Berman DS, Shaw LJ, Kiat H, Cohen I, Cabico JA, et al. Incremental prognostic value of myocardi- al perfusion single photon emission computed tomography for the prediction of cardiac death: differential stratifica- tion for risk of cardiac death and myocardial infarction. Circulation 1998;97:535-43.
  • Emond M, Mock MB, Davis KB, Fisher LD, Holmes DR Jr, Chaitman BR, et al. Long-term survival of medically trea- ted patients in the Coronary Artery Surgery Study (CASS) Registry. Circulation 1994;90:2645-57.
  • De Backer G, Ambrosioni E, Borch-Johnsen K, Brotons C, Cifkova R, Dallongeville J, et al. European guidelines on cardiovascular disease prevention in clinical practice. Third Joint Task Force of European and Other Societies on Cardiovascular Disease Prevention in Clinical Practice. Eur Heart J 2003;24:1601-10.
  • Antithrombotic Trialists' Collaboration. Collaborative meta- analysis of randomised trials of antiplatelet therapy for prevention of death, myocardial infarction, and stroke in high risk patients. BMJ 2002;324:71-86.
  • Patrono C, Coller B, FitzGerald GA, Hirsh J, Roth G. Platelet-active drugs: the relationships among dose, effec- tiveness, and side effects: the Seventh ACCP Conference on Antithrombotic and Thrombolytic Therapy. Chest 2004;126(3 Suppl):234S-264S.
  • Grundy SM, Cleeman JI, Merz CN, Brewer HB Jr, Clark LT, Hunninghake DB, et al. Implications of recent clinical trials for the National Cholesterol Education Program Adult Treatment Panel III Guidelines. J Am Coll Cardiol 2004;44:720-32.
  • A randomised, blinded, trial of clopidogrel versus aspirin in patients at risk of ischaemic events (CAPRIE). CAPRIE Steering Committee. Lancet 1996;348:1329-39.
  • Indications for ACE inhibitors in the early treatment of acute myocardial infarction: systematic overview of indi- vidual data from 100,000 patients in randomized trials. ACE Inhibitor Myocardial Infarction Collaborative Group. Circulation 1998;97:2202-12.
  • Domanski MJ, Exner DV, Borkowf CB, Geller NL, Rosenberg Y, Pfeffer MA. Effect of angiotensin converting enzyme inhibition on sudden cardiac death in patients following acute myocardial infarction. A meta-analysis of randomized clinical trials. J Am Coll Cardiol 1999;33:598-604.
  • Freemantle N, Urdahl H, Eastaugh J, Hobbs FD. What is the place of beta-blockade in patients who have experienced a myocardial infarction with preserved left ventricular functi- on? Evidence and (mis)interpretation. Prog Cardiovasc Dis 2002;44:243-50.