Heart : official journal of the British Cardiac Society
-
Comparative Study
Computed tomography versus exercise electrocardiography in patients with stable chest complaints: real-world experiences from a fast-track chest pain clinic.
To compare the diagnostic performance of CT angiography (CTA) and exercise electrocardiography (XECG) in a symptomatic population with a low-intermediate prevalence of coronary artery disease (CAD). ⋯ CTA is feasible and diagnostic in more patients than XECG. For interpretable studies, CTA has a higher sensitivity, but lower specificity for detection of CAD.
-
South America comprises widely different environments consisting of many complex and heterogeneous ethnicities, societies and cultures. During recent decades conspicuous advances in human and societal development have been made. South America now faces three major demographic shifts: population growth; urbanisation (almost 90% of the population live in urban areas) and ageing. ⋯ Urbanisation has brought unfavourable and prominent changes, such as increased smoking rates, stress, lack of physical activity and poor diets (more fat and calories). Consequently, owing to the interaction between environment and genetic susceptibility, the modifications induced by urbanisation have resulted in enhancement of the cardiovascular risk factors and cardiovascular disease (CVD). This situation is responsible for the burden of CVD in South America, requiring effective action towards better detection and control of cardiovascular risk factors aimed at reducing the burden of disease in the region, which tends to be higher and increasingly serious.
-
Coronary artery stenting is increasingly used as a treatment for coronary artery disease. A period of antiplatelet therapy is mandatory following coronary stenting, in order to minimise the risk of stent thrombosis. About 5% of patients who undergo coronary stenting will require non-cardiac surgery within 12 months, and the management of antiplatelet therapy in this setting is complex, requiring a balance between the risks of both operative haemorrhage and stent thrombosis. The available evidence to guide decision-making in the management of antiplatelet therapy in this setting is reviewed.