Atheroma: More than mush
Atheroma: More than mush
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DOI：
10.1016/s0140-6736(96)98002-2
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发表时间：
1996-11-01
期刊：
影响因子：
168.9
通讯作者：
Libby, P
中科院分区：
文献类型：
--
作者：
Libby, P
这些原则是高度发展和完善的，但仍然是深入改进和评估的主题。这里的问题是确保新的发展及其实施以科学和证据为指导，而不是以技术的诱惑和工业的利益为指导。许多患有未被识别但可治疗的CHD的人是改善社区CHD整体管理的进一步目标，因此也是二级预防。许多心绞痛患者仍未确诊。更糟糕的是，许多患有不稳定冠状动脉综合征的人逃避了紧急医疗管理的好处。这张网也可能被撒得更广，以识别具有可逆性疾病的早期证据的患者，如内皮功能障碍所表现的。现在，这是一种非侵入性测试的实际可能性，尽管迄今为止只是作为一种研究程序。内皮功能障碍易于改善，并可能提供一个替代治疗的目标。在许多方面的进展，尤其是在冠心病的病因、预防和管理的许多方面的积极交流，正在结合起来，带来一种真实的和进一步迫在眉睫的进展。本文已是一个概括性的观点。其余的补充是采取了专家的意见，冠心病，结束了一个心脏病患者的见解。
The principles are highly developed and well-established though still the subject of intensive refinement and evaluation. The issue here is to ensure that new developments and their implementation are guided by science and evidence, rather than by the seductions of technology and the interests of industry. The many people with unrecognised but treatable CHD are a further target for improving overall management of CHD in the community, and thus also its secondary prevention. Many with angina remain undiagnosed. Worse still, many with unstable coronary syndrome escape the benefits of urgent medical management. The net might also be cast more widely to identify patients with very early evidence of reversible disease, as manifest by endothelial dysfunction. This is now a practical possibility with non-invasive tests, albeit only as a research procedure to date. Endothelial dysfunction is amenable to improvement and could perhaps provide a surrogate target for therapy. Advances on many fronts, not least of communication between those active in the many aspects of CHD causation, prevention, and management, are combining to bring a sense of real and further imminent progress. This article has been a general view. The rest of the Supplement is taken up with specialist views of CHD, ending with the insights of a cardiologist-patient.