ABSTRACT
BACKGROUND: The beginnings of coronary artery bypass graft in Latin America could be set in the year 1971. Since then, improvements in technique and greater experience have resulted in a rapid increase in the rate of interventions performed in the region. METHODS AND RESULTS: Searches through PubMed and Literatura Latinoamericana y del Caribe en Ciencias de la Salud, as well as personal communications from specialists from Latin America, have been the source of information. Articles were selected by their content related to the theme, and the authors' nationality and information is mainly from Latin America. Demographic information of the population of Latin America denotes higher age averages, and this implies an increase in the severity of comorbidities in patients who undergo surgery. Longer life expectancy and improvements in medical therapy have implied that patients survive a first intervention beyond the expected time a bypass persists patent. Wall vessel properties of arterial conduits, plus a better anastomotic technique, seem to be the current solution to worsening in the coronary health of patients who undergo revascularization surgery in Latin America. CONCLUSIONS: Despite scarce economic investment in medical sciences, many academic groups contribute to the exploration of therapeutic pharmacological combinations and inclusively apply genetic strategies.
Subject(s)
Coronary Artery Bypass/methods , Coronary Disease/surgery , Adult , Age Factors , Aged , Aged, 80 and over , Angioplasty, Balloon, Coronary , Atherosclerosis/epidemiology , Cardioplegic Solutions , Combined Modality Therapy , Comorbidity , Coronary Artery Bypass/economics , Coronary Artery Bypass/mortality , Coronary Artery Bypass/statistics & numerical data , Coronary Artery Bypass/trends , Coronary Disease/epidemiology , Coronary Disease/therapy , Coronary Restenosis/epidemiology , Coronary Restenosis/surgery , Diabetes Mellitus/epidemiology , Diet , Female , Fibrinolytic Agents/therapeutic use , Genetic Therapy , Humans , Hyperlipidemias/epidemiology , Latin America/epidemiology , Male , Middle Aged , Myocardial Infarction/surgery , Obesity/epidemiology , Platelet Aggregation Inhibitors/therapeutic use , Randomized Controlled Trials as Topic , Reoperation , Risk Factors , Socioeconomic FactorsABSTRACT
PURPOSE OF REVIEW: There is an enormous literature on the prevention of myocardial infarction. However, most articles are focused categorically on evidence-based medicine and give no room for conceptual analyses. In this article, we attempt to review the main aspects of this theme from a different point of view. RECENT FINDINGS: In the last decade, scientists have encouraged the understanding and gradual application of genetics in the study of common diseases. This is one of the main angles from which we try to review the prevention of myocardial infarction. Another important factor is the consideration of cost-effectiveness. Consequently, we remark on the value of interventions that can have an impact on cost. SUMMARY: In preventing myocardial infarction modern physicians should emphasize the importance of behavioral and cultural changes and learn from genetic advances in restoring the delicate balance that is altered in atherosclerotic disease.
