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沙特心脏协会慢性冠状动脉综合征管理最佳实践指南。

Saudi Heart Association Guidelines on Best Practices in the Management of Chronic Coronary Syndromes.

作者信息

AlShammeri Owayed, Al Saif Shukri, Al Shehri Halia, Alasng Mirvat, Qaddoura Fatema, Al Shehri Mohammad, Turkistani Yosra, Tash Adel, Alharbi Walid, Al Qahtani Fahad, Diaz Rafael, Mahaimeed Wael, Al Habeeb Waleed, Alfaraidy Khalid

机构信息

Dr. Sulaiman Al-Habib Hospital, Riyadh, Saudi Arabia.

Saud Albabtain Cardiac Center, Dammam, Saudi Arabia.

出版信息

J Saudi Heart Assoc. 2022 Nov 18;34(3):182-211. doi: 10.37616/2212-5043.1320. eCollection 2022.

Abstract

BACKGROUND

The prevalence of both chronic coronary syndrome (CCS) and its risk factors is alarming in Saudi Arabia and only a minority of patients achieve optimal medical management. Context-specific CCS guidelines outlining best clinical practices are therefore needed to address local gaps and challenges.

CONSENSUS PANEL

A panel of experts representing the Saudi Heart Association (SHA) reviewed existing evidence and formulated guidance relevant to local clinical practice considering the characteristics of the Saudi population, the Saudi healthcare system, its resources and medical expertise. They were reviewed by external experts to ensure scientific and medical accuracy.

CONSENSUS FINDINGS

Recommendations are provided on the clinical assessment and management of CCS, along with supporting evidence. Risk reduction through non-pharmacological therapy (lifestyle modifications) remains at the core of CCS management. Great emphasis should be placed on the use of available pharmacological options (anti-anginal therapy and event prevention) only as appropriate and necessary. Lifestyle counseling and pharmacological strategy must be optimized before considering revascularization, unless otherwise indicated. Revascularization strategies should be carefully considered by the Heart Team to ensure the appropriate choice is made in accordance to current guidelines and patient preference.

CONCLUSION

Conscientious, multidisciplinary, and personalized clinical management is necessary to navigate the complex landscape of CCS in Saudi Arabia considering its population and resource differences. The reconciliation of international evidence and local characteristics is critical for the improvement of healthcare outcomes among CCS patients in Saudi Arabia.

摘要

背景

在沙特阿拉伯,慢性冠状动脉综合征(CCS)及其危险因素的患病率令人担忧,只有少数患者能实现最佳医疗管理。因此,需要制定针对具体情况的CCS指南,概述最佳临床实践,以解决当地的差距和挑战。

共识小组

一个由代表沙特心脏协会(SHA)的专家组成的小组审查了现有证据,并根据沙特人口的特点、沙特医疗保健系统、其资源和医学专业知识,制定了与当地临床实践相关的指南。这些指南由外部专家进行审查,以确保科学和医学准确性。

共识结果

提供了关于CCS临床评估和管理的建议以及支持证据。通过非药物治疗(生活方式改变)降低风险仍然是CCS管理的核心。应高度重视仅在适当和必要时使用可用的药物选择(抗心绞痛治疗和事件预防)。在考虑血运重建之前,必须优化生活方式咨询和药物治疗策略,除非另有指示。心脏团队应仔细考虑血运重建策略,以确保根据当前指南和患者偏好做出适当选择。

结论

考虑到沙特阿拉伯的人口和资源差异,在沙特阿拉伯应对CCS的复杂情况时,认真、多学科和个性化的临床管理是必要的。协调国际证据和当地特点对于改善沙特阿拉伯CCS患者的医疗结果至关重要。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1b71/9762239/7a16c2ff4c2c/sha182-211f1.jpg

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