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(Journal Article) |
Revue medicale suisse 6 (267): 1951-4, 1956 (2010)
[Stable and asymptomatic coronary heart disease: a new paradign].
Carole Baumgartner
,
Marco Roffi
,
Arnaud Perrier
,
Sebastian Carballo
ABSTRACT
Whilst optimal management of acute coronary syndromes and, in particular, the value of an early invasive strategy including revascularization, is well defined, the treatment of asymptomatic and stable coronary artery disease (CAD) has been more empirical. Recent studies clarify the benefits of different strategies. Strict control of cardiovascular risk factors (CVRF), with pharmacological intervention if necessary, remains the cornerstone of CAD management. Systematic screening of asymptomatic patients, even in categories such as those with diabetes, is not recommended. Furthermore, initial revascularization in patients with stable coronary heart disease, and no high risk lesions or disabling angina, has no benefit over medical management of CVRF.