Dia: 3 de novembro de 2014
Vale a pena procurar isquemia coronária no DM assintomático?
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Conclusions High-risk asymptomatic patients with DM and normal MPS (78%) have a low rate of first manifestations of CAD. Patients with abnormal MPS at baseline (22%) have a 7-fold higher rate of progression to “overt or silent CAD,” despite therapy. Randomized patients’ outcomes suggest that a combined invasive and medical strategy for silent CAD may reduce scintigraphic but not symptomatic CAD progression versus medical therapy alone.
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http://imaging.onlinejacc.org/article.aspx?articleID=1905468
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O que o editorial aponta:
In BARDOT, those treated conservatively had considerably lower rates of antiplatelet agents and statins prescribed; hence, there appears to be an opportunity to optimize medical therapy in those with normal nuclear stress tests..
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http://imaging.onlinejacc.org/article.aspx?articleid=1913659
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Veja abaixo outro estudo com ecocardiograma:
http://echotalkblog.com/2008/06/10/stress-echocardiography-in-diabetes-mellitus/
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Veja abaixo que o ecoestresse é o único exame com boa relação custo-benefício:
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