Naar minder hartinfarcten door preventieve aanpak!


Een groot internationaal onderzoek heeft aangetoond dat het open maken van alle verstopte slagaders met een stent na een ernstige hartaanval veel beter is dan het open maken van alleen de verstopte slagader die de hartaanval veroorzaakte.
Ongeveer de helft van alle slachtoffers van een hartaanval blijkt extra verstopte slagaders te hebben naast degene die hun hartaanval heeft veroorzaakt.

Voor dit onderzoek openden artsen enkel die ene slagader die verantwoordelijk was voor de hartaanval
.

Gangbare medisch beleid te heroverwegen!

De  nieuwe studie waarbij 31 landen betrokken waren toont nu aan dat het openmaken van alle vernauwingen beter is dan alleen maar deze slagader te behandelen die verantwoordelijk was voor de acute hartaanval.
Deze preventieve aanpak zorgde voor een vermindering van het risico van de patiënt om te overlijden of  om nog een hartaanval te krijgen
met 26%.

Door de omvang en het internationale karakter van dit onderzoek zal het bestaande medische beleid omtrent acute hartaanvallen moeten herbekeken worden, om jaarlijks vele duizenden terugkerende hartaanvallen voorkomen.

Waarom deze preventieve aanpak?

Het gunstige effect van het openen van een geblokkeerde slagader, die de hartaanval veroorzaakte, met een stent  was reeds langer  gekend bij cardiologen.
Toch was het tot dusver onduidelijk of extra stents in het bloedvaten circuit  eventuele vernauwingen konden verhelpen om zo een nieuwe hartaanval of vroegtijdig overlijden te vermijden.

Cardiologen vreesden ook dat ze door het inbrengen van extra stents bijkomende schade zouden veroorzaken doordat er meer contrastvloeistof moet gebruikt worden.
Misschien zouden ze wel stents plaatsen waar het eigenlijk niet nodig was...
Bovendien was tot nu de meerwaarde van deze preventieve aanpak alles behalve duidelijk: Zou deze aanpak schelen in het aantal hartaanvallen of in een verminderde sterfte?
Daarom werden eventuele andere vernauwingen tot nu toe enkel onder controle gehouden met medicatie zoals  bloedverdunners.

Deze studie heeft duidelijk aangetoond dat het op lange termijn voordelen biedt om ernstige hartgerelateerde  problemen te voorkomen door alle bloedvaten te wijder te maken.
Er waren ook geen grote nadelen aan deze aanvullende procedure.”

onderzoeksleider Dr. Shamir R. Mehta van de Population Health Research Institute (PHRI) van McMaster University en Hamilton Health Sciences.


Het onderzoek
Bij dit internationale onderzoek waren 4041 hartpatiënten betrokken.
Deze personen werden voor het onderzoek in 2 groepen verdeeld.
De eerste groep onderging de gangbare procedure en bij de andere groep werden alle bloedvaten rond het hart gecontroleerd en eventueel aangepakt met een stent.
In de daaropvolgende 3 jaar kregen uit de eerste groep, 160 mensen een nieuw hartinfarct.
In de tweede groep waren dit 109 mensen.
Een belangrijk verschil dus.

Sterfgevallen

Uit het onderzoek bleek geen verschil te zijn tussen beide behandelingswijzen voor wat betreft het aantal sterfgevallen.
Wel is het zo dat bij ieder nieuw hartinfarct de functies van het hart steeds minder worden, hetgeen uiteindelijk wel kan leiden tot meer sterfgevallen.
Met deze nieuwe aanpak zou
het aantal sterfgevallen bij  hartpatiënten verder kunnen terug gedrongen worden.

Het onderzoek werd gepubliceerd in het vakblad The New England Journal of Medicine.

De resultaten werden als een klinische studie gepresenteerd op  het European Society of Cardiology Congress en op het World Congress of Cardiology in Parijs.

Bron: brighterworld.mcmaster.ca

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Requiem: Chapter 5
- Just in time Stephen March could save himself from a certain death with a lateral leap. The bright red glider drilled into the window of ' Redstone & Son ', a branch of a Western electronics company that had gained a foothold in the New World. One of the first groups to have won this authorization after the Second Cold War. The reinforced windows of the electronics store were no match for the kinetic forces of the runaway vehicle. The window glass splits into countless small pieces. At the last moment, Stephen had seen the murder vehicle rushing at him in the light of the window window. His rapid reaction, an instinctive reflex at the moment itself - was happiness or perhaps the result of his daily workout - had given him that small chance and saved his life. Because most of the pieces of glass had been broken up by the movement of the glider inside the shop space, March had not suffered any serious cuts. His pants and vest were torn and smeared by the fall, and his left leg was a little worse planed by the unsoft contact with the concrete, but the rest was not easy.. While he was still recovering from the first shock, he heard above the panicked screams of the pedestrians who witnessed the event, from the store a metallic scraping. To his great surprise, he saw the red carlide moving out of the storefront and turning to him. Stephen frowned amazed the eyebrows. Apparently, that killing machine was targeting him. This wasn't a coincidence, not an ordinary accident.. His hunch shouted at him a single word: “Run!’. He took the first street on the right at a delirious pace, almost slipping he could just avoid a pedestrian who was angry behind him. A second later he heard a bons accompanied by a creepy scraping sound. Stephen looked backwards and saw the unfortunate passerby crushed by the chasing autobot slipping along the wall in a blood-red pattern. The fear knocked him in the throat, the adrenaline made him run even faster. He thought the Metro, I should get it.. There, the runaway computer car wouldn't be able to follow him. He jumped up the stairs with two steps at the same time that would lead him to the main street via a few inland roads and also to the entrance of the underground train network. Whenever he reached the end of one of those roads, he heard the murderous vehicle approaching and blowing his neck like a hot breath. He walked even faster, and it seemed like he was given wings because of the fear that drove him. Eventually he came into the street where the entrance to the Metro was. He saw it as a redeeming mouth that would swallow it up. Another ten meters. With his last breath he squeezed out one last sprint. With a tiger jump, he plunged forward down the stairs and hurtfully rolled to the bottom of the entrance, where he hoped to be safe from the murderous autobot. Stephen felt vomited. It was a miracle, but apparently he didn't break anything at first sight, even though he was in pain everywhere. He crawled stumbling and leaning against a pillar again upright. The red monster remained hovering in front of the entrance to the Metro for a while and then disappeared out of sight.. People looked at him with fear, and many walked around him in a wide bow.. In the light of a window of a train he saw the reason. He just looked like a wreck. In the toilet of the underground, he tried to decent his clothes some and take up the worst damage. All in all, it turned out to be too easy. All his muscles were stiff due to the intense effort but nothing felt broken to. He bled from a number of small wounds to the elbows and hands. The abrasions on his leg did not look really life-threatening, although it had to be taken care of professionally. Stephen should see a doctor as soon as possible for a skilled patch. Now he no longer looked like a diplomat Stephen March, but more like a clochard who had walked into the wall several times in his alcoholic haze... or perhaps fell down the stairs of the Metro. His first idea was to tell the police everything and file a complaint against strangers. Only then did he realize that he had not seen a license plate number on his murderous stalker. In the New World all gliders or autobots were numbered on the bottom, the doors and the top of the vehicles. So one could immediately see or find out which city or area they came from. In addition, the windows were darkened so that he could not disclose the face of the driver or occupants. weird! He would wait a while to visit the police. His sixth sense told him that he might do more harm than good with that.. After an hour on the emergency service of the nearest hospital, he was given the necessary iodine tincture, special adhesive plasters containing an antibiotic and gauze dressing - and what was especially important - a strong painkiller. His leg was not broken, but still hit worse than he had previously suspected. Stephen told the doctor on duty that he had fallen from the stairs of the subway entrance due to a misstep and sustained those injuries. Even if that was only half the truth, it wasn't a lie. It sounded really convincing how Stephen brought it, but this explanation also avoided any annoying questions from the doctor on duty or a mandatory visit to the law services. Stephen March didn't get high on the Security Service right now, especially after the unsolved murder of his half-sister Suzy. The idea of walking a block and a little more at Redstone & Son to inquire, he also rejected. Maybe any witnesses recognized him while the police were still there investigating the case. What intrigued him most of all was the reason behind this unexpected attack on his person. Why was he attacked, hunted like a wild animal, eventually he was also nearly killed? What was the point, what was behind this, was this connected to Suzy's murder?? All the questions haunted in his head. He felt hunted and anxious and looked around as he sought his way back. When he was back at his apartment, he first poured himself a good whiskey.. He knew that it was not wise to mix medicines and alcohol, but this was an exception to the rule. His hand was still shaking slightly when the golden moisture was poured into the crystal glass. He took a big sip of Chivas Regal. Stephen felt the fluid that immediately warmed him a way to his stomach, which now settled some. Stephen let the last hours before his mind's eye pass. After the identification with Suzy's personal items he had received from Mr. Huang, he went for a walk in the shopping streets of Sanctuary. Getting his feelings back under control after the psychological thump he got in the morgue. Then suddenly the red homicide vehicle that showed up at him? Stephen put the rest of his whiskey glass aside and poured out the contents of the canary yellow plastic bag with his sister's personal belongings, whom he miraculously could have saved during all those struggles of the last few hours, onto the table. There were the usual things that are usually found in the possessions of a woman. First of all, her torn and bloody garments, which he laid apart with due respect and a great piece of dismay. Another example of the lack of sympathy from the New World police forces. In the pocket there was also a torn handbag, a broken lip gloss, a key ring, a hairbrush that had also suffered under the trap, a crushed pack of started paper wipes and a wallet with some banknotes in it, some pictures, but all her credit cards were missing or withheld by the Security Service. Scattered, he was messing around in all the boxes of her wallet when he found between two pictures in a note pleated in two. March immediately recognized Suzy Chang's beautiful female handwriting. There was only one word on it and a number: “Passage 6.”. It didn't tell him anything. That couldn't be the note Captain Vastai was talking about. The conscious note that referred to him? The key ring of four keys he weighed equally predominantly in his palm. He immediately recognized the blue rectangles key of an autobot. Number SW280387. Nothing was referring to that Passage 6. One of the other three keys must have been from Suzy's apartment since the name was printed in the key bar of the residence where she was staying: ' Pinewood House Asurai ’. A number was printed on the tip of the bar: 837. As he already knew, this referred to the eighth floor apartment 37. The other two were still a mystery to him. A mystery that he would certainly try to solve. He wouldn't ask the police what those keys were for.. By the way, if they had been of some interest, he probably wouldn't have gotten it.. Maybe today he took a walk to Pinewood House Asurai. Stephen changed and took the elevator to the underground garage with a painful grimace on his face in his own autobot and entered the address of the residence. The speech recognition program looked this up in its internal memory, started the almost silent drive system and the vehicle automatically slipped into the traffic jam of the pre-programmed route. Stephen leaned weary backwards in the seat and waited with his eyes closed for him to reach his destination.. copyright Rudi J.P. Lejaeghere Requiem: Chapter 4 or 6 - Requiem: Chapter 4 - Requiem: Chapter 6 -
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