Interventional cardiology in 2012: comparability of Croatia with international trends

Boris Starcevic, Irzal Hadzibegovic, Mario Sicaja, Igor Rudez
2013 Cardiologia Croatica  
8(1-2):3. Cardiologia CROATICA SAAEETAK: Intervencijska kardiologija jedno je od najbraee rastuÊih podruËja danaπnje medicinske znanosti, a tehnoloπka i farmakoloπka otkriÊa unutar tog podruËja unazad samo nekoliko godina dovela su do znaËajnih promjena u lijeËenju i prognozi bolesnika sa srËanoaeilnim bolestima. Prvenstveno je uloga intervencijske kardiologije u poboljπanju ishoda lijeËenja najjasnije vidljiva u akutnom koronarnom sindromu, a uspjeπne mreaee primarne perkutane koronarne
more » ... ne koronarne intervencije u akutnom infarktu miokarda predstavljaju jedno od najveÊih dostig-nuÊa moderne kardiologije, a moaeda i medicine uopÊe. Dok je uloga intervencijske kardiologije u akutnoj koronarnoj bolesti jasna, stabilna koronarna bolest srca i dalje ostaje predmet javne rasprave te predmet brojnih istraaeivanja. Nove tehnologije i materijali u lijeËenju koronarne bolesti srca od 2012. postaju dostupne diljem svijeta, pa tako i u Hrvatskoj, a njihova implementacija is-kljuËivo ovisi o financijskim okolnostima. Novi antitrombocitni i antiagregacijski lijekovi takoer su predmet istraaeivanja, a sve u potrazi za (poaeeljno) jednim lijekom koji Êe u kardiovaskularnoj intervenciji imati najbolji omjer uËinkovitosti i sigurnosti. Ova godina bila je i godina punog zamaha intervencijskog lijeËenja strukturne bolesti srca, napose aortne stenoze i mitralne regurgitacije, a kardioembolizacija, arterijska hipertenzija i periferna vaskularna bolest takoer postaju sve πire "igraliπte" za intervencijske kardiologe. U ovom preglednom Ëlanku prikazali smo sve te moderne trendove u intervencijskoj kardiologiji protekle godine u svijetu i usporedili ih sa stanjem u Hrvatskoj. KLJU»NE RIJE»I: koronarna bolest srca, intervencijska kardiologija, akutni koronarni sindrom, stent. ABSTRACT: Interventional cardiology has became among the fastest growing areas in clinical medicine, thanks to technological and pharmacological discoveries over the last few years, which brought important advancements in treatment and overall prognosis of patients with cardiovascular diseases. Benefits of primary interventional treatments became particularly evident in management of acute coronary syndrome, especially in circumstances of organized network of primary percuteneous coronary interventions, which represented a crucial step in development of modern era in cardiology, or even medicine. On the other hand, interventional management of chronic ischemic heart disease recently came to greater focus of attention as the issue of professional challenge, due to exceedingly grown number of investigations. New technologies and devices for treatment of coronary artery disease have become available in 2012 in the world market, as well as in Croatia. However, their implementation for the most depends on availability of financial resources. Further efforts were made around research on novel antiplatelet and antiaggregation drugs, with an aim to develop the agent that would preferably exert greater efficiency, within more favorable safety profile. This was the year in which interventional treatment extended on the structural heart diseases as well particularly due to increase in treatment of aortic stenosis and mitral regurgitation, whilst cardioembolization, arterial hypertension and peripheral vascular disease become ever more attractive "battlefield" for interventional cardiologists. In this review article, we have presented all those modern trends in interventional cardiology in the past year at an international level and compared them to the situation in Croatia. KEYWORDS: coronary heart disease, interventional cardiology, acute coronary syndrome. CITATION: Cardiol Croat. 2013;8(1-2):3-10. Perkutane koronarne intervencije i stabilna koronarna bolest srca Iako je indikacija i korist primarne PCI u akutnom koronarnom sindromu (AKS) neupitna i poduprta nizom visokovrijednih dokaza, PCI u stabilnoj koronarnoj bolesti srca (KBS) i dalje ostaje predmet velike rasprave koja se vodi izmeu predstavnika intervencijske kardiologije, kardiokirurgije, ali i neinvazivne kardiologije. Nakon objave rezultata COURA-GE ispitivanja 2007. god. koje je kod randomiziranih 2287
doi:10.15836/ccar.2013.3 fatcat:eb5zfejjprd5pll6owymmzshdq