Article Abstract:
A review of the literature on the treatment of coronary artery disease found that women may benefit from many of the strategies used on men, including thrombolytic drugs, percutaneous transluminal coronary angioplasty (PTCA) and coronary artery bypass grafting (CABG). Thrombolytic drugs break up the blood clots that cause most heart attacks. Thrombolytic therapy substantially reduces mortality after a heart attack in both men and women, although the reduction in mortality is not as great in women as it is in men. PTCA was initially found to be less effective in women, but this may have been because the balloons used were too big. The studies show that women have more complications during the procedure, but have a similar long-term outcome as men. The same is true for CABG; long-term survival is the same in women as in men, although fewer women may experience relief from angina. The higher complication rate in women may be a reflection of their older age.
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Article Abstract:
A prospective, randomized trial is used to determine the optimal strategy for using the platelet glycoprotein IIb/IIIa (Gp IIb/IIIa) inhibitors in patients with moderate- and high-risk acute coronary syndromes (ACS) who are undergoing an early, invasive treatment strategy. The investigations have shown that deferring the routine upstream use of Gp IIb/IIIa inhibitors for selective administration to patients has resulted in an increase in composite ischemia that has not met the criterion for noninferiority.
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Article Abstract:
Patients with coronary artery disease that only affects one artery will probably do best with angioplasty while those with more extensive disease affecting several arteries will benefit most from bypass surgery. All patients should eliminate as many modifiable risk factors as possible and should take drugs that lower cholesterol levels.
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