Download or read book Treatment Strategies for Women with Coronary Artery Disease written by and published by . This book was released on 2012 with total page pages. Available in PDF, EPUB and Kindle. Book excerpt: OBJECTIVES: Although coronary artery disease (CAD) is the leading cause of death for women in the United States, treatment studies to date have primarily enrolled men and may not reflect the benefits and risks that women experience. Our systematic review of the medical literature assessed the comparative effectiveness of major treatment options for CAD specifically in women. The comparisons were (1) percutaneous coronary intervention (PCI) versus fibrinolysis/supportive pharmacologic therapy in ST elevation myocardial infarction (STEMI), (2) early invasive versus initial conservative management in non-ST elevation myocardial infarction (NSTEMI) or unstable angina, and (3) PCI versus coronary artery bypass surgery (CABG) versus optimal medical therapy in stable or unstable angina. The endpoints assessed were clinical outcomes, modifiers of effectiveness by demographic and clinical factors, and safety outcomes. DATA SOURCES: MEDLINE(r), PubMed(r), Embase(r), and Cochrane Database of Systematic Reviews. REVIEW METHODS: Randomized controlled trials published in English from January 1, 2001, to December 12, 2011, comparing the treatment options for CAD listed above and containing sex-specific outcomes. Clinical outcomes were classified as short term (|́Þ30 days), intermediate term (1 year), or long term (>1 year). Random-effects meta-analysis was performed for studies with similar outcomes measured at similar time points. RESULTS: Twenty-eight comparative studies contributed evidence about effectiveness, modifiers of effectiveness, or safety for the comparisons described above. For women with STEMI, five studies showed a reduction in composite outcomes (primarily death/MI/stroke) at 30 days for PCI over fibrinolysis (odds ratio [OR] 0.50; 95% CI, 0.36 to 0.72; high strength of evidence [SOE]); there was insufficient evidence for assessing outcomes at 1 year. For women with NSTEMI or unstable angina, the included studies, although not showing statistical significance, suggested a benefit of early invasive over initial conservative management for the composite outcome of primarily death/MI at 6 months and 1 year (2 studies, OR 0.77; CI, 0.28 to 2.12; low SOE; 5 studies, OR 0.78; CI, 0.54 to 1.12; low SOE). Evidence, however, suggested a small benefit of initial conservative management at 5 years (2 studies, OR 1.05; CI, 0.81 to 1.35). Given the small suggested benefit at 5 years, the wide confidence interval crossing 1, and the trend favoring early invasive therapy suggested at earlier time points and across time points in men--we cannot support firm conclusions (insufficient SOE). For women with stable angina randomized to revascularization (PCI or CABG) or medical therapy, three studies showed a reduction in the composite outcome of death/MI/repeat revascularization at 5 years for revascularization with either PCI (OR 0.64; CI, 0.47 to 0.89; moderate SOE) or CABG (OR 0.56; CI, 0.32 to 0.96; low SOE). For stable and unstable angina trials comparing PCI with CABG, two studies suggested a nonsignificant benefit of PCI in mortality at 30 days (low SOE). At 1 year and beyond, although suggestive of a benefit of CABG in for the composite outcomes of death/MI/stroke for women, this finding was not statistically significant and represented wide confidence intervals (low SOE at 1 year and at>2 years). Five studies assessed modifiers of effectiveness in women due to demographic factors (|́Æ65 or |́Æ80 years of age) or clinical factors (risk stratification or diabetes). Strength of evidence for modifiers of effectiveness for STEMI, NSTEMI, and stable/unstable angina was insufficient. Four studies assessed safety outcomes in women: two STEMI studies (PCI versus fibrinolysis) and two NSTEMI studies (PCI versus CABG) assessed transfusion rates, incidence of intracranial hemorrhage, and bleeding rates. Strength of evidence for safety outcomes for all the CAD presentations was insufficient. CONCLUSIONS: From a limited number of studies reporting results for women separately from the total study population, our findings confirm current practice and evidence for care in one of the three areas evaluated. For women with STEMI, we found that an invasive approach with immediate PCI is superior to fibrinolysis for reducing cardiovascular events, which is similar to findings in previous meta-analyses combining results for both women and men. For women with NSTEMI or unstable angina, evidence suggested that an early invasive approach reduces cardiovascular events; however, it was not statistically significant. Previous meta-analyses of studies comparing early invasive with initial conservative strategies on a combined population of men and women showed a significant benefit of early invasive therapy. We also found that the few trials reporting sex-specific data on revascularization compared with optimal medical therapy for stable angina showed a greater benefit with revascularization for women, while the men in the study fared equally well with either treatment. In contrast, previous meta-analyses that combined results for men and women found similar outcomes for either treatment. Limitations include a small number of trials with data for women available for meta-analysis, varying definitions of composite outcomes, and variable timing of followup. Future studies should collect and report clinical outcomes and harms in women by treatment strategy and at each followup time point--including subgroup data on important demographic and clinical factors that may modify clinical effectiveness--so that firmer conclusions can be reached about the risk and benefit of these therapies in women.

Download or read book Treatment Strategies for Women With Coronary Artery Disease written by and published by . This book was released on 2012 with total page 0 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Treatment Strategies for Women With Coronary Artery Disease written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-07 with total page 50 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cardiovascular disease remains the leading cause of death among women in the United States. More than 500,000 women die of cardiovascular disease each year, exceeding the number of deaths in men and the next seven causes of death in women combined. This translates into approximately one death every minute. This report focuses on women because of the differences in clinical presentation and extent and location of coronary disease on presentation, which affect the treatment options for coronary artery disease (CAD). Currently available guidelines and systematic reviews provide specific treatment recommendations for women only among a subset of treatment options, and overall assume that treatment options are equally effective for both sexes when gender data are not available. However, women have a worse prognosis than men for manifestations of CAD such as acute myocardial infarction, and some data suggest that women and men may not respond equally to the same treatments. Further, women are more likely than men to experience bleeding complications. In 2012, a Comparative Effectiveness Review (CER), “Treatment Strategies for Women With Coronary Artery Disease,” attempted to assess the comparative effectiveness of the major treatment options for CAD specifically in women, evaluating these comparisons: 1. Percutaneous coronary intervention (PCI) versus fibrinolysis or PCI versus conservative/supportive medical management in women with ST elevation myocardial infarction (STEMI) 2. Early invasive versus initial conservative management in women with unstable angina or non-ST elevation myocardial infarction (UA/NSTEMI) 3. PCI versus coronary artery bypass graft surgery (CABG) versus optimal medical therapy in women with stable or unstable angina Given the clinical and economic importance of treating CAD in women, the ongoing investment in CAD research on medical therapy, PCI and CABG, and the remaining areas of uncertainty, we sought to create a prioritized future research agenda that would represent the interests of diverse stakeholders and allow the remaining areas of uncertainty to be addressed.

Download or read book Treatment Strategies for Women with Coronary Artery Disease written by and published by . This book was released on 2013 with total page 47 pages. Available in PDF, EPUB and Kindle. Book excerpt:

Download or read book Treatment Strategies for Women with Coronary Artery Disease written by U. S. Department of Health and Human Services and published by CreateSpace. This book was released on 2013-03-28 with total page 218 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cardiovascular disease remains the leading cause of death among women in the United States. More than 500,000 women die of cardiovascular disease each year, exceeding the number of deaths in men and the next seven causes of death in women combined. This translates into approximately one death every minute. Coronary artery disease (CAD)—which includes coronary atherosclerotic disease, myocardial infarction (MI), acute coronary syndrome, and angina—is the most prevalent form of cardiovascular disease and is the largest subset of this mortality. An estimated 16.3 million Americans 20 years of age and older have CAD, and the overall CAD prevalence is 7 percent in adults in the United States (8.3% for men, 6.1% for women). The prevalence of CAD is higher in men than in women across different age groups until they reach 75 years of age, giving the perception that CAD is a male-specific disease. This report focuses on women because of the differences in clinical presentation and coronary anatomy, which affect the treatment options for CAD. Currently available guidelines and systematic reviews provide specific treatment recommendations for women only among a subset of treatment options and overall assume that treatment options are equally effective for both sexes when gender data are not available. However, women have a worse prognosis than men for manifestations of CAD such as acute myocardial infarction, and some data suggest that women and men do not respond equally to the same treatments. Further, women are more likely than men to experience bleeding complications. In women, CAD is misdiagnosed or not treated as aggressively as in men or is under researched. Multiple factors are likely to contribute to the lower use of evidence-based medicine (medical therapy and/or coronary revascularization) and the higher rate of cardiovascular complications among women with CAD. These factors include: Cardiovascular disease affects women later in life; At the time CAD is diagnosed, women are more likely to have comorbid factors such as diabetes mellitus, hypertension, hypercholesterolemia, peripheral vascular disease, and heart failure; Women present with angina-equivalent symptoms such as dyspnea or atypical symptoms more often than men; The coronary vessels in women tend to be smaller than those of men, which makes them more difficult to revascularize percutaneously and surgically, and microvascular disease of the coronary arteries is more common in women than in men; Women tend to have less extensive CAD and a higher proportion of nonobstructive CAD; Delay in hospitalization, symptom pattern and recognition, and higher frequency of nonobstructive CAD ultimately results in delay in diagnosis and effective treatment; Because of underrepresentation of women in randomized controlled trials (RCTs), a lack of solid data on cardiovascular disease in women leaves uncertainty about the risk–benefit ratio of treatment. Thus, a better understanding of the evidence for the effectiveness of medical treatment and revascularization therapies specifically in women is needed in order to reduce cardiovascular events in women. Although CAD is the leading cause of death for women in the United States, treatment studies to date have primarily enrolled men and may not reflect the benefits and risks that women experience. We conducted this systematic review of the medical literature to assess the comparative effectiveness of the major treatment options for CAD specifically in women, evaluating these comparisons: 1. PCI versus fibrinolysis or PCI versus conservative/supportive medical management in women with STEMI; 2. Early invasive versus initial conservative management in women with UA/NSTEMI; 3. PCI versus CABG versus optimal medical therapy in women with stable or unstable angina. The endpoints assessed were clinical outcomes, modifiers of effectiveness by demographic and clinical factors, and safety outcomes.

Download or read book The Women s Healthy Heart Program written by Nieca Goldberg and published by Ballantine Books. This book was released on 2008-12-10 with total page 482 pages. Available in PDF, EPUB and Kindle. Book excerpt: WINNER OF THE BOOKS FOR A BETTER LIFE AWARD One out of every two women will die of heart disease. It is the single greatest health risk for women today–more than stroke and all cancers combined. In the course of her practice, and as chief of Women’s Cardiac Care at New York’s Lenox Hill Hospital, Dr. Nieca Goldberg has come to a startling realization: Women experience heart disease in a fundamentally different way than men do. The physiology of a woman’s heart attack is not the same as a man’s, the symptoms of heart disease and signs of impending heart attack differ for women, and once heart disease has been recognized, women often do not get the treatment and medications they require. Now here are detailed, age-specific programs that give women the facts and the guidance they need to recognize, treat, and prevent heart disease, including • how you can rate your risk of heart disease • the effects of menopause on your heart • risk factors you can change–starting today • a heart-healthy exercise plan that works for you • a complete guide to heart-healthy supplements • the truth about hormone replacement therapy and the heart • recovering from a heart attack or surgery Authoritative, caring, and up-to-the-minute, this is the women’s health book for the new millennium.

Download or read book Women are Not Small Men written by Nieca Goldberg and published by . This book was released on 2002 with total page 488 pages. Available in PDF, EPUB and Kindle. Book excerpt: The single greatest health risk for women today-more than stroke and all cancers "combined-is heart disease. Yet despite this documented fact, heart disease is still considered primarily a "male problem," with the result that far too many women go untreated by doctors and are misinformed by the existing literature. Now, with this groundbreaking new book, Dr. Nieca Goldberg, the nation's leading expert on women's heart disease, has at last remedied this situation. "Women "Are Not Small Men presents detailed, decade-by-decade programs that give women at any age OF life the facts and the guidance they need to recognize, treat, and prevent heart disease. In the course of her work as founder and chief of the Women's Heart Program at New York's Lenox Hill Hospital, Dr. Goldberg has come to a startling realization: Women experience heart disease in a fundamentally different way than men do. The physiology of a woman's heart attack is not the same as a man's, the symptoms of heart disease and signs of impending heart attack differ for women, and once heart disease has been recognized, women often do not get the treatment and medications they need. In this accessible book, she uses these critical insights to build a complete treatment and prevention program geared to the unique needs of women. Engagingly written and grounded in compelling true patient stories, the book presents comprehensive instructions on what you can do to maintain or improve your heart health, including how to spot the warning signs of heart disease, the exercises and diet to follow for prevention and recovery, how to assess risk factors, techniques for reducing stress, the truth about estrogen and hormonereplacement therapy, which supplements and herbal remedies really work, and how to become your own advocate in dealing with the medical profession. Dr. Nieca Goldberg has made it her mission to give women the treatment and information they deserve. Now she makes her research, prevention program, and recovery strategies accessible to all women. Authoritative, caring, and up-to-the-minute, this is destined to become the women's health book of the new millennium.

Download or read book Saving Women s Hearts written by Martha Gulati and published by John Wiley & Sons. This book was released on 2011-02-11 with total page 273 pages. Available in PDF, EPUB and Kindle. Book excerpt: Mention the term "heart disease" and most people picture an overweight, middle-aged man. Yet the reality is that heart disease is the number one killer of women in North America, accounting for a third of all deaths in women and far surpassing the prevalence of breast cancer. Cardiologist Dr. Martha Gulati and holistic pharmacist Sherry Torkos separate the facts from the many myths surrounding heart disease and offer the latest information on both the conventional medical approach and the role of natural medicine in understanding this illness. Saving Women's Hearts examines the unique gender differences for women and provides valuable insight into the screening procedures, diagnosis, treatment options, and most importantly, prevention of heart disease. Written by the leading experts in this field, this practical guide covers: How the heart works and the various types of heart disease Why heart disease is different and unique for women The known and emerging risk factors for heart disease What you need to know about tests and screening procedures Medications - the good, the bad, the ugly, the noteworthy Nature's Pharmacy - the role of vitamins and other supplements Nutritional strategies for better heart health The latest exercise guidelines for women The impact of stress and practical tips on managing stress The role of sleep and heart health And much more...

Download or read book Preventive Cardiology written by JoAnne Micale Foody and published by Springer Science & Business Media. This book was released on 2000-11-10 with total page 369 pages. Available in PDF, EPUB and Kindle. Book excerpt: Leading clinicians and researchers concisely review the significant risk factors, including dyslipidemias, hypertension, diabetes, lack of exercise, obesity, tobacco, and homocysteine, and outline the best preventive strategies available. They also offer an overview of the new paradigms in coronary artery disease pathophysiology, including the nature of the unstable atherosclerotic plaque, new strategies for the modification of plaque constituents, the importance of the endothelium in the maintenance of cardiovascular health, and the emerging roles of oxidative stress, infection, and inflammation. Comprehensive and pathbreaking, Preventive Cardiology: Strategies for the Prevention and Treatment of Coronary Artery Disease provides physicians with the understanding and tools necessary to bring the practice of preventive cardiology to their patients.

Download or read book Cardiovascular Disability written by Institute of Medicine and published by National Academies Press. This book was released on 2010-12-04 with total page 304 pages. Available in PDF, EPUB and Kindle. Book excerpt: The Social Security Administration (SSA) uses a screening tool called the Listing of Impairments to identify claimants who are so severely impaired that they cannot work at all and thus immediately qualify for benefits. In this report, the IOM makes several recommendations for improving SSA's capacity to determine disability benefits more quickly and efficiently using the Listings.

Download or read book Coronary Artery Disease and Related Conditions Management written by Jo Gulledge and published by Jones & Bartlett Learning. This book was released on 1999 with total page 310 pages. Available in PDF, EPUB and Kindle. Book excerpt: Inside this book, you'll find the essentials for administering heart disease management programs, with detailed information on developing and implementing clinical pathways and guidelines, measuring and managing outcomes, and reinforcing patient satisfaction. Including treatment strategies for unstable angina, myocardial infarction, congestive heart failure and more, Coronary Artery Disease and Related Conditions Management: Clinical Pathways, Guidelines, and Patient Education is an ideal resource for health care providers working to provide more cost-effective and outcome-oriented care. In addition, you'll find a host of large-print patient education handouts, including Spanish-language patient information sheets, designed for clinicians across the care continuum to distribute freely to patients.

Download or read book Disease Control Priorities Third Edition Volume 5 written by Dorairaj Prabhakaran and published by World Bank Publications. This book was released on 2017-11-17 with total page 948 pages. Available in PDF, EPUB and Kindle. Book excerpt: Cardiovascular, respiratory, and related conditions cause more than 40 percent of all deaths globally, and their substantial burden is rising, particularly in low- and middle-income countries (LMICs). Their burden extends well beyond health effects to include significant economic and societal consequences. Most of these conditions are related, share risk factors, and have common control measures at the clinical, population, and policy levels. Lives can be extended and improved when these diseases are prevented, detected, and managed. This volume summarizes current knowledge and presents evidence-based interventions that are effective, cost-effective, and scalable in LMICs.

Download or read book Cardiovascular Health and Disease in Women written by Pamela S. Douglas and published by Saunders. This book was released on 2002 with total page 568 pages. Available in PDF, EPUB and Kindle. Book excerpt: This practical resource takes a close look at an emerging issue in woman's health*the gender difference in cardiovascular disease. Health care providers involved in the care of female patients can rely on this extraordinary reference for the latest coverage of cardiovascular health and disease. The new 2nd Edition features an expanded scope that offers more information on patient care approaches, risk factors, hormones and CAD, and more. New chapters cover hot topics such as estrogen, diet and nutrition, first- and second-degree prevention strategies, managing CAD, and acute coronary syndromes. A much broader scope presents more information on patient care, risk factors, hormones and CAD, and clinical manifestations of CAD. New authors bring an up-to-date perspective to material that focuses on their areas of expertise. New chapters provide the latest information on hot topics, including: Nutrition, Antioxidants and Inflammation, Primary Prevention in Women, Lessons from Human Trials, Management of Chronic Stable Angina, Acute Coronary Syndromes, Angiography and Angioplasty, Coronary Artery Surgery, Implementation Strategies for Secondary Prevention, Syndrome X and Coronary Vascular Resistance, and Normal Cardiovascular Physiology Updates and new information have been incorporated throughout, and substantial revisions have been made to chapters on: Diabetes Mellitus and Obesity, Smoking, Clotting and Thrombosis, Physical Activity, Lessons from Animal Models, Prescribing HRT, Diagnostic Testing Valvular Heart Disease, CHF and Myocardial Dysfunction, Stroke and PVD, Preexisting Heart Disease, and Diagnostic and Therapeutic Strategies Expanded discussions of estrogen address both the underlying science and clinical applications for practice Strategies for first- and second-degree prevention of disease offer a proactive approach to treatment and patient care

Download or read book Coronary Artery Disease written by Gregory W. Barsness and published by Springer Science & Business Media. This book was released on 2011-12-07 with total page 196 pages. Available in PDF, EPUB and Kindle. Book excerpt: A book directed towards individuals with an interest in the clinical treatment of patients with unrevascularizable angina. It explores the treatment options in the setting of a sound scientific background and provides guidance and predictions for future directions in this rapidly developing field. It is the only textbook of its kind and fulfils an unmet need for practicing internal medicine, family practice and cardiovascular clinicians. It also provides a reliable reference for clinical and basic researchers interested in this topic.

Download or read book Translational Research in Coronary Artery Disease written by Wilbert S. Aronow and published by Academic Press. This book was released on 2015-10-29 with total page 246 pages. Available in PDF, EPUB and Kindle. Book excerpt: Translational Research in Coronary Artery Disease: Pathophysiology to Treatment covers the entire spectrum of basic science, genetics, drug treatment, and interventions for coronary artery disease. With an emphasis on vascular biology, this reference fully explains the fundamental aspects of coronary artery disease pathophysiology. Included are important topics, including endothelial function, endothelial injury, and endothelial repair in various disease states, vascular smooth muscle function and its interaction with the endothelium, and the interrelationship between inflammatory biology and vascular function. By providing this synthesis of current research literature, this reference allows the cardiovascular scientist and practitioner to access everything they need from one source. - Provides a concise summary of recent developments in coronary and vascular research, including previously unpublished data - Summarizes in-depth discussions of the pathobiology and novel treatment strategies for coronary artery disease - Provides access to an accompanying website that contains photos and videos of noninvasive diagnostic modalities for evaluation of coronary artery disease

Download or read book Novel Strategies in Ischemic Heart Disease written by Umashankar Lakshmanadoss and published by BoD – Books on Demand. This book was released on 2012-02-29 with total page 466 pages. Available in PDF, EPUB and Kindle. Book excerpt: The first edition of this book will provide a comprehensive overview of ischemic heart disease, including epidemiology, risk factors, pathogenesis, clinical presentation, diagnostic tests, differential diagnosis, treatment, complications and prognosis. Also discussed are current treatment options, protocols and diagnostic procedures, as well as the latest advances in the field. The book will serve as a cutting-edge point of reference for the basic or clinical researcher, and any clinician involved in the diagnosis and management of ischemic heart disease. This book is essentially designed to fill the vital gap existing between these practices, to provide a textbook that is substantial and readable, compact and reasonably comprehensive, and to provide an excellent blend of "basics to bedside and beyond" in the field of ischemic heart disease. The book also covers the future novel treatment strategies, focusing on the basic scientific and clinical aspects of the diagnosis and management of ischemic heart disease.

Download or read book Clinical Approach and Management Strategies of Medical Ailments in Women written by Shibba Takkar Chhabra and published by Jaypee Brothers Medical Publishers. This book was released on 2020-04-30 with total page 481 pages. Available in PDF, EPUB and Kindle. Book excerpt: