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State of the art treatment of coronary Heart Disease : Medical therapy vs PCI/CABG in stable CHD and ACS
State-of-the-art Treatment of Coronary Heart Disease
The treatment of coronary artery disease (CAD) encompas-ses many strategies all of which aim to improve symptoms and prognosis. While in the acute coronary syndrome, early revascularisation (usually by means of PCI and stent implan-tation) is the urgent goal of treatment, drug therapy initially has only a supportive role here but is also important for im-proving prognosis. The situation is reversed in the case of the treatment of chronic stable CAD: here conservative drug the-rapy has the dominant role and if implemented optimally is so successful that the prognosis cannot be further improved with additional PCI and stent implantation.Therefore, the indi-cation for revascularisation should not only be based on an angiographic but also on a functional (FFR, fractional flow re-serve) assessment of the stenosis. Nevertheless, optimised drug therapy is often only used suboptimally, while interven-tional therapy is often used too frequently and is viewed as the modern and only correct therapy. The evidence presen-ted aims to finally dispel all this! This book is therefore a critical presentation of the benefit of treatment strategies in the different forms of CAD. In addition to the value of lifestyle changes, it deals with the evaluation of the various drug therapies, invasive procedures such as PCI and stent implantation, bypass surgery and electrotherapeu-tic measures with ICD, CRT and cardiac pacemakers. The authors have succeeded in producing a textbook that is not just of interest to the attending doctor but also for patients af-fected by the disease. A textbook from the viewpoint: what is optimal? What is economic? What is evidence-based?
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