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Minerva Cardioangiologica 2020 Feb 20

DOI: 10.23736/S0026-4725.20.05069-0

Copyright © 2020 EDIZIONI MINERVA MEDICA

language: English

Interventional procedures versus medical therapy alone: outcome of cardiac patient management. A systematic review

Ahmed ABUOSA, Ayman ELSHIEKH, Abdulhalim J. KINSARA

Ministry of National Guard Health Affair, King Abdullah International Medical Research Center, King Saud Bin Abdulaziz University for Health Sciences, COM-WR, Jeddah, Saudi Arabia


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BACKGROUND: Cardiac patients are managed medically or with an intervention. This review aims to explore the survival benefit of each approach in the management of cardiac patients.
METHODS: We reviewed updated evidence of survival benefit from the most recent trials and guidelines.
RESULTS: Patients with ST-segment-elevation myocardial infarction (STEMI) have a mortality benefit when a Primary Cardiac Intervention is implemented. No similar benefit has been shown in chronic stable coronary artery disease. Heart failure patients show a mortality benefit using medication and similarly, mild or moderate valve disease patients do not require an intervention. In atrial fibrillation, the CABANA trial using ablation therapy, had no mortality benefit. Hypertension drug therapy showed a significant mortality benefit, a similar benefit was noted with drug therapy for the treatment of dyslipidemia, when achieving the target lipid goal.
CONCLUSIONS: Not all interventional procedures result in a mortality benefit. Medical therapy alone increases survival in many cardiac diseases.


KEY WORDS: Early medical intervention; Early intervention; Patient outcome assessment; Practice guideline

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