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Testing Acetylcholine Followed by Adenosine for Invasive Diagnosis of Coronary Vasomotor Disorders
Published on: February 3, 2021
[Should i treat a high risk chronic coronary syndrome invasively from the beginning? Yes, in most cases]
César Antonio Ortiz Zegarra1,2, Piero Custodio Sánchez3,4, Paol Rojas de la Cuba5,6
1Médico asistente del Servicio de Cardiología Intervencionista. Instituto Nacional Cardiovascular - INCOR. Lima. Perú. Servicio de Cardiología Intervencionista Instituto Nacional Cardiovascular - INCOR Lima Perú.
Insights
For chronic coronary syndrome (CCS) in high-risk patients, early invasive management improves quality of life, though not mortality. Individual assessment is key, considering treatment availability and risks.
Area of Science:
- Cardiology
- Interventional Cardiology
Context:
- Chronic coronary syndrome (CCS), formerly stable coronary disease, is a leading global cause of mortality and a significant health concern in Peru.
- CCS presents a dynamic nature with diverse clinical scenarios amenable to various therapeutic interventions.
Purpose:
- To analyze current information on the management of high ischemic risk CCS.
- To determine the optimal therapeutic strategy for patients with CCS and high ischemic risk (ischemia >10% left ventricular mass).
Summary:
- Individual evaluation suggests that invasive management from the outset is appropriate for high ischemic risk CCS.
- While not impacting overall mortality or cardiovascular events, invasive treatment can enhance patient quality of life.
Impact:
- Highlights the importance of personalized treatment strategies for CCS.
- Underscores the need to consider treatment accessibility, symptomatic management options, and potential adverse effects in Peru.
- Invasive management offers a pathway to improved quality of life for high-risk CCS patients.
Abstract:
Chronic coronary syndrome (SCC) previously known as stable coronary disease, is the main cause of mortality in the world, and it is one of the most important in Peru. This pathology has a dynamic nature that results in different clinical scenarios that can be modified through various therapeutic options, one of which is coronary interventional treatment, mainly in patients with high ischemic risk defined as ischemia greater than 10% of the entire left ventricular mass. For this reason, we have analyzed the most relevant and current information available, concluding that the treatment of high ischemic risk´s chronic coronary syndrome, after an individual evaluation, would correspond to an invasive management from the beginning, although it would not impact on mortality or cardiovascular events, it would contribute to improve quality of life; also we should consider the incomplete availability of all the therapeutic options for the symptomatic management of this disease, the limited access to the management of acute cardiovascular events in our country, as well as the risk of adverse effects and drug interactions.
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