Thoracic aortic disease medical therapy: Difference between revisions

Jump to navigation Jump to search
VisualWikitext
(/* 2010 ACCF/AHA Guideline Recommendations: Evaluation and Management of Acute Thoracic Aortic Disease (DO NOT EDIT) {{cite journal| author=Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE et al.| title=2010 ACCF/AHA/AATS/ACR/ASA/S...)
(/* 2010 ACCF/AHA Guideline Recommendations: Inflammatory Diseases Associated with Thoracic Aortic Disease (DO NOT EDIT) {{cite journal| author=Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE et al.| title=2010 ACCF/AHA/AATS/ACR/AS...)
Line 11: Line 11:
|-
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Stringent control of [[hypertension]], [[lipid profile]] optimization, [[smoking cessation]], and other [[atherosclerosis]] risk-reduction measures should be instituted for patients with small aneurysms not requiring surgery, as well as for patients who are not considered to be surgical or stent graft candidates. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Stringent control of [[hypertension]], [[lipid profile]] optimization, [[smoking cessation]], and other [[atherosclerosis]] risk-reduction measures should be instituted for patients with small aneurysms not requiring surgery, as well as for patients who are not considered to be surgical or stent graft candidates. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]])'' <nowiki>"</nowiki>
|}
==2010 ACCF/AHA Guideline Recommendations: Inflammatory Diseases Associated with Thoracic Aortic Disease (DO NOT EDIT) <ref name="pmid20233780">{{cite journal| author=Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE et al.| title=2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine. | journal=Circulation | year= 2010 | volume= 121 | issue= 13 | pages= e266-369 | pmid=20233780 | doi=10.1161/CIR.0b013e3181d4739e | pmc= | url=http://www.ncbi.nlm.nih.gov/entrez/eutils/elink.fcgi?dbfrom=pubmed&tool=sumsearch.org/cite&retmode=ref&cmd=prlinks&id=20233780  }} </ref>==
===Recommendations for Takayasu Arteritis and Giant Cell Arteritis===
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LightGreen"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class I]]
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''1.''' Initial therapy for active [[Takayasu arteritis]] and active [[giant cell arteritis]] should be [[corticosteroid]]s at a high dose ([[prednisone]] 40 to 60 mg daily at initiation or its equivalent) to reduce the active inflammatory state. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])'' <nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''2.''' The success of treatment of patients with Takayasu arteritis and giant cell arteritis should be periodically evaluated to determine disease activity by repeated physical examination and either an [[erythrocyte sedimentation rate]] or [[C-reactive protein]] level. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|-
| bgcolor="LightGreen"|<nowiki>"</nowiki>'''3.''' Elective [[revascularization]] of patients with [[Takayasu arteritis]] and [[giant cell arteritis]] should be delayed until the acute inflammatory state is treated and quiescent. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: B]])''<nowiki>"</nowiki>
|}
{|class="wikitable"
|-
| colspan="1" style="text-align:center; background:LemonChiffon"|[[ACC AHA guidelines classification scheme#Classification of Recommendations|Class IIa]]
|-
|bgcolor="LemonChiffon"|<nowiki>"</nowiki>'''1.''' It is reasonable to treat patients with [[Takayasu arteritis]] receiving [[corticosteroid]]s with an additionalanti-inflammatory agent if there is evidence of progression of vascular disease, recurrence of constitutional symptoms, or re-elevation of inflammatory marker. ''([[ACC AHA guidelines classification scheme#Level of Evidence|Level of Evidence: C]]) '' <nowiki>"</nowiki>
|}
|}


Revision as of 17:36, 31 October 2012


Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]

Overview

2010 ACCF/AHA Guideline Recommendations: General Medical Treatment and Risk Factor Management (DO NOT EDIT) [1]

Recommendation for Medical Treatment of Patients with Thoracic Aortic Diseases

Class I
"1. Stringent control of hypertension, lipid profile optimization, smoking cessation, and other atherosclerosis risk-reduction measures should be instituted for patients with small aneurysms not requiring surgery, as well as for patients who are not considered to be surgical or stent graft candidates. (Level of Evidence: C) "

2010 ACCF/AHA Guideline Recommendations: Aortic Arch and Thoracic Aortic Atheroma and Atheroembolic Disease. (DO NOT EDIT) [1]

Recommendations for Aortic Arch and Thoracic Aortic Atheroma and Atheroembolic Disease

Class IIa
"1. Treatment with a statin is a reasonable option for patients with aortic arch atheroma to reduce the risk of stroke. (Level of Evidence: C)"
Class IIb
"1. Oral anticoagulation therapy with warfarin (INR 2.0 to 3.0) or antiplatelet therapy may be considered in stroke patients with aortic arch atheroma 4.0 mm or greater to prevent recurrent stroke. (Level of Evidence: C)"

References

  1. ↑ 1.0 1.1 Hiratzka LF, Bakris GL, Beckman JA, Bersin RM, Carr VF, Casey DE; et al. (2010). "2010 ACCF/AHA/AATS/ACR/ASA/SCA/SCAI/SIR/STS/SVM guidelines for the diagnosis and management of patients with Thoracic Aortic Disease: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines, American Association for Thoracic Surgery, American College of Radiology, American Stroke Association, Society of Cardiovascular Anesthesiologists, Society for Cardiovascular Angiography and Interventions, Society of Interventional Radiology, Society of Thoracic Surgeons, and Society for Vascular Medicine". Circulation. 121 (13): e266–369. doi:10.1161/CIR.0b013e3181d4739e. PMID 20233780.

Template:WH Template:WS

Retrieved from "https://www.wikidoc.org/index.php?title=Thoracic_aortic_disease_medical_therapy&oldid=785733"