sexta-feira, junho 22, 2012

Faça o exame das Carótidas.

Risk will also be higher than indicated in the charts in:

Asymptomatic individuals with preclinical evidence of
atherosclerosis, for example, the presence of plaques or
increased carotid intima–media thickness (CIMT) on
carotid ultrasonography.
Very high risk:

Documented CVD by invasive or non-invasive testing (such as
coronary angiography, nuclear imaging, stress echocardiography,
carotid plaque on ultrasound), previous myocardial infarction
(MI), ACS, coronary revascularization [percutaneous coronary
intervention (PCI), coronary artery bypass graft (CABG)] and
other arterial revascularization procedures, ischaemic stroke,

Carotid artery disease
Several trials have shown the beneficial effects of lipid-lowering
therapy on the progression of CIMT and on the prevention of
CV events. A meta-analysis of 10 studies including 3443 patients
reported a significant reduction in the progression of carotid atherosclerosis
in statin-treated patients compared with placebo, and a
more recent systematic review also showed a significant CIMT
regression after statin therapy. In a meta-analysis of RCTs enrolling
.90 000 patients, Amarenco et al. reported that statin therapy
determines a 21% reduction in the incidence of all strokes in different
populations, with a strong correlation between LDL-C
reduction and CIMT, pointing to a 0.73% per year reduction of
CIMT for each 10% decrease of LDL-C. Recent studies also
suggest that nicotinic acid may add to the protective effect of
De onde foram tiradas essas recomendações? De uma diretriz de carótidas?

ESC/EAS Guidelines for the management of dyslipidaemias 2011

Dá para entender um ecocardiografista que não saiba estudar as Carótidas?????

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