1,721,186 research outputs found
Genezen is beter dan voorkomen
Full text linkIn de tweede helft van de vorige eeuw waren hart en vaatziekten de belangrijkste
doodsoorzaak in Nederland. Dit is lang zo gebleven, maar na een piek rond 1970 is de
sterfte aan hart en vaatziekten, gecorrigeerd voor de leeftijd, gedaald en sinds enkele
jaren staan hart en vaatziekten op de tweede plaats wat betreft de sterfte percentages.
(figuur 1) Dit is een verdienste van de cardiologie en de vasculaire geneeskunde.
De levensverwachting in Nederland en in andere westerse landen is in die jaren
belangrijk toegenomen. Dat komt vooral door enorme verbeteringen in de preventie
en behandeling van hart en vaatziekten in 40 jaar. De helft van deze winst komt door
betere preventie en de helft door betere behandeling van de ziekte.
Afscheidsrede Prof. dr. Maarten L. Simoons
hoogleraar Cardiologie
Erasmus Universiteit Rotterdam,
uitgesproken 17 december 201
Chronic stable coronary artery disease: Drugs vs. revascularization
Full text linkCoronary artery disease remains the leading cause of mortality in most industrialized countries, although age-standardized mortality related to coronary artery disease (CAD) has decreased by more than 40 during the last two decades. Coronary atherosclerosis may cause angina pectoris, myocardial infarction, heart failure, arrhythmia, and sudden death. Medical management of atherosclerosis and its manifestation aims at retardation of progression of plaque formation, prevention of plaque rupture, and subsequent events and treatment of symptoms, when these occur as well as treatment of the sequelae of the disease. Revascularization by either percutaneous coronary intervention (PCI) or coronary artery bypass surgery (CABG) is performed as treatment of flow-limiting coronary stenosis to reduce myocardial ischaemia. In high-risk patients with acute coronary syndromes (ACS), a routine invasive strategy with revascularization in most patients provides the best outcome with a significant reduction in death and myocardial infarction compared with an initial conservative strategy. Conversely, the benefit of revascularization among patients with chronic stable CAD has been called into question. This review will provide information that revascularization exerts favourable effects on symptoms, quality of life, exercise capacity, and survival, particularly in those with extensive CAD and documented moderate-to-severe ischaemia. Accordingly, CABG and PCI should be considered a valuable adjunct rather than an alternative to medical therapy
Clinical Perspectives. Interpretation of trials with drug and devices; a double standard?
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