In certain patients with stable angina who are at moderate to high risk, coronary bypass surgery or coronary angioplasty are the therapeutic options of choice.
However, in selected other patients the use of anti-ischemic drug therapy and secondary prevention reduce episodes of myocardial ischemia and result in a good long-term prognosis.
Factors affecting management include the extent of coronary disease, the magnitude of cardiac symptoms, the severity of myocardial ischemia and of left ventricular function.
Based upon these and other clinical characteristics, patients can be divided into low-moderate-or high-risk categories for morbidity and mortality.
Patients at high risk are more likely to be selected for myocardial revascularization and patients at low risk are often treated with medical therapy, at least initially.
Based on the available cost-effectiveness data, medical therapy or coronary angioplasty are the preferred initial strategies for low-risk coronary disease, whereas coronary bypass surgery (CABG) is recommended for many high-risk patients, particularly for those with triple-vessel disease and impaired left ventricular function or ischemia at a low workload.
CABG is cost-effective for patients with severe angina and left main coronary artery disease and also for patients with mild angina and triple-vessel disease.
Coronary angioplasty is cost-effective for patients with severe angina, and single-or multivessel disease. (...)
Mots-clés Pascal : Angine poitrine, Chronique, Analyse coût efficacité, Economie santé, Vasodilatateur coronarien, Dérivation, Aortocoronaire, Dilatation instrumentale, Etude longitudinale, Traitement, Mortalité, Homme, Appareil circulatoire pathologie, Cardiopathie coronaire, Chirurgie, Traitement instrumental
Mots-clés Pascal anglais : Angina pectoris, Chronic, Cost efficiency analysis, Health economy, Coronary vasodilator agent, Bypass, Aortocoronary, Instrumental dilatation, Follow up study, Treatment, Mortality, Human, Cardiovascular disease, Coronary heart disease, Surgery, Instrumentation therapy
Notice produite par :
Inist-CNRS - Institut de l'Information Scientifique et Technique
Cote : 96-0393797
Code Inist : 002B12A03. Création : 10/04/1997.