Enfoque actual del tratamiento farmacológico del síndrome coronario agudo sin elevación del segmento st. de la fisiopatología al manejo
Los síndromes coronarios agudos son un problema mayor de salud pública en todo el mundo. El síndrome coronario agudo (SCA) incluye infarto agudo de miocardio (IAM), con o sin elevación del ST y la angina inestable. La incidencia anual de IAM sin elevación del segmento ST es 565.000 nuevos eventos y...
- Autores:
-
Acosta Ariza, María Angélica
Romo Escorcia, Fabio Camilo
- Tipo de recurso:
- Trabajo de grado de pregrado
- Fecha de publicación:
- 2016
- Institución:
- Universidad Libre
- Repositorio:
- RIU - Repositorio Institucional UniLibre
- Idioma:
- spa
- OAI Identifier:
- oai:repository.unilibre.edu.co:10901/10239
- Acceso en línea:
- https://hdl.handle.net/10901/10239
- Palabra clave:
- Síndrome coronario agudo
Salud pública
Infarto agudo de miocardio
ENFERMEDAD CORONARIA
Síndromes coronarios agudos
Epidemiología
Diagnóstico
- Rights
- openAccess
- License
- http://creativecommons.org/licenses/by-nc-nd/2.5/co/
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Enfoque actual del tratamiento farmacológico del síndrome coronario agudo sin elevación del segmento st. de la fisiopatología al manejo |
| title |
Enfoque actual del tratamiento farmacológico del síndrome coronario agudo sin elevación del segmento st. de la fisiopatología al manejo |
| spellingShingle |
Enfoque actual del tratamiento farmacológico del síndrome coronario agudo sin elevación del segmento st. de la fisiopatología al manejo Síndrome coronario agudo Salud pública Infarto agudo de miocardio ENFERMEDAD CORONARIA Síndromes coronarios agudos Epidemiología Diagnóstico |
| title_short |
Enfoque actual del tratamiento farmacológico del síndrome coronario agudo sin elevación del segmento st. de la fisiopatología al manejo |
| title_full |
Enfoque actual del tratamiento farmacológico del síndrome coronario agudo sin elevación del segmento st. de la fisiopatología al manejo |
| title_fullStr |
Enfoque actual del tratamiento farmacológico del síndrome coronario agudo sin elevación del segmento st. de la fisiopatología al manejo |
| title_full_unstemmed |
Enfoque actual del tratamiento farmacológico del síndrome coronario agudo sin elevación del segmento st. de la fisiopatología al manejo |
| title_sort |
Enfoque actual del tratamiento farmacológico del síndrome coronario agudo sin elevación del segmento st. de la fisiopatología al manejo |
| dc.creator.fl_str_mv |
Acosta Ariza, María Angélica Romo Escorcia, Fabio Camilo |
| dc.contributor.advisor.none.fl_str_mv |
Cano Rivera, Rodolfo Iglesias Acosta, Jesús |
| dc.contributor.author.none.fl_str_mv |
Acosta Ariza, María Angélica Romo Escorcia, Fabio Camilo |
| dc.subject.spa.fl_str_mv |
Síndrome coronario agudo Salud pública Infarto agudo de miocardio |
| topic |
Síndrome coronario agudo Salud pública Infarto agudo de miocardio ENFERMEDAD CORONARIA Síndromes coronarios agudos Epidemiología Diagnóstico |
| dc.subject.lemb.spa.fl_str_mv |
ENFERMEDAD CORONARIA |
| dc.subject.proposal.spa.fl_str_mv |
Síndromes coronarios agudos Epidemiología Diagnóstico |
| description |
Los síndromes coronarios agudos son un problema mayor de salud pública en todo el mundo. El síndrome coronario agudo (SCA) incluye infarto agudo de miocardio (IAM), con o sin elevación del ST y la angina inestable. La incidencia anual de IAM sin elevación del segmento ST es 565.000 nuevos eventos y 300.000 ataques recurrentes cada año. Los factores de riesgo para presentar síndromes coronarios agudos incluyen: tabaquismo, niveles elevados de lípidos séricos, hipertensión arterial, diabetes mellitus, obesidad mórbida, sedentarismo, bajo consumo diario de frutas y vegetales, consumo problemático de alcohol e índice psicosocial. La evaluación inicial de un SCA SEST debe enfocarse en el dolor torácico, signos y síntomas asociados y factores de riesgo para SCA. Los marcadores biológicos de lesión miocárdica han evolucionado en la actualidad para una mejor precisión del abordaje diagnóstico y aportan datos para el pronóstico de los pacientes. El manejo actual de las nuevas drogas utilizadas mejora el pronóstico, disminuyen la mortalidad y mejoran la calidad de vida de los pacientes. Esta revisión bibliográfica se realizó con el propósito de actualizar los conocimientos sobre la fisiopatología el diagnóstico y el tratamiento del síndrome coronario agudo sin elevación del ST. |
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2016 |
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2016 |
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2017-07-26T19:41:20Z |
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2017-07-26T19:41:20Z |
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Tesis de Especialización |
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info:eu-repo/semantics/acceptedVersion |
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http://purl.org/coar/resource_type/c_7a1f |
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info:eu-repo/semantics/bachelorThesis |
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http://purl.org/coar/resource_type/c_7a1f |
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acceptedVersion |
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https://hdl.handle.net/10901/10239 |
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instname:Universidad Libre |
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reponame:Repositorio Institucional Universidad Libre |
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https://hdl.handle.net/10901/10239 |
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Robert P. Giugliano, Christopher P. Cannon y Eugene Braunwald, Tratado De Cardiología, Texto De Medicina Cardiovascular, Síndromes Coronarios Agudos Sin Elevación Del ST, 10 ed. Volumen 1, El sevier. 2016; 53: 1155- 1181. |
| dc.relation.references.eng.fl_str_mv |
Lozano R, Naghavi M, Foreman K. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010, The Lancet. 2012; 380:2095. Allan A. World Health Organization. Global status report on non-communicable diseases 2011. [Fecha de consulta: 25 de abril de 2016]. Disponible en: http://www.who.int/nmh/publications/ncd_report2010/es/. Cubillos LA, Casas JP, Morillo C, Bautista LE. Congestive heart failure in Latin America: the next epidemic Am Heart J 2004; 147:412–7. Mack M, Gopal A, Ambarish Gopal, Epidemiology, Traditional and Novel Risk Factors in Coronary Artery Disease, Cardiol Clin 32 (2014) 323–332 Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet. 2007; 370:1929-38. Stamler J, Stamler R, Neaton JD. Low riskfactor profile and long-term cardiovascular and noncardiovascular mortality and life expectancy: findings for 5 large cohorts of young adult and middle-aged men and women. JAMA. 2012; 1999:282 Lloyd-Jones DM, Hong Y, Labarthe D. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s Strategic Impact Goal Through 2020 And Beyond. Circulation 2010; 121:586. Sarwar N, Butterworth AS, Freitag DF. IL6R Genetics Consortium Emerging Risk Factors Collaboration, Interleukin-6 receptor pathway in coronary heart disease: a collaborative metaanalysis of 82 studies. Lancet 2012; 379:1205. Karakas M, Koenig W, Zierer A. Myeloperoxidase is associated with incident coronary heart disease independently of traditional risk factors: results from the MONICA/KORA Augsburg study. J Intern Med 2012; 271:43. Kamin DS, Grinspoon SK. Cardiovascular disease in HIV-positive patients. AIDS 2005; 19:641. Roberts R, Steward AF. Genes and coronary artery disease: where are we? J Am Coll Cardiol 2012; 18:1715–21. ohn M. Canty y Dirk J. Duncker, Tratado De Cardiología, Texto De Medicina Cardiovascular, Flujo Sanguíneo Coronario E Isquemia Miocardica, 10 ed. Volumen 1, El sevier, 2016; 49: 1029-1055. Liu Y, Gutterman DD: Vascular Control In Humans: Focus On The Coronary Microcirculation, Basic Res Cardiol. 2009; 104:211. Beyer AM, Gutterman DD: Regulation of the human coronary microcirculation, J Mol Cell Cardiol. 2012; 52:814 Zhang C, Rogers PA, Merkus D, et al: Regulation of coronary microvascular resistance in health and disease. In Tuma RF, Duran WN, Ley K, editors: Microcirculation, Boston, 2008, Elsevier, p 521. Deussen A, Ohanyan V, Jannasch A. Mechanisms of metabolic coronary flow regulation, J Mol Cell Cardiol. 2012; 52:794. Allam A, Thompson R. Atheroesclerosis In Ancient Egyptian Mummies, J am Coll Cardiol Img. 2011; 4 (4):315-327. Chopra H.K, Nanda N. Cardiology: a clinical and historical perspective, the history of the acute coronary syndrome, 1ra edición. 2013; 12:87-90. Gimbrone MA, García-Cardena G. Vascular endothelium, hemodynamics, and the pathobiology of atherosclerosis, Cardiovasc Pathol. 2013: 22:9. Pijls NH, Sels JW. Functional measurement of coronary stenosis, J Am Coll Cardiol. 2012; 59:1045. De Bruyne B, Pijls NH, Kalesan B. Fractional flow reserve-guided pci versus medical therapy in stable coronary disease, N Engl J Med. 2012; 367:991. Camici PG, Olivotto I, Rimoldi OE. The coronary circulation and blood flow in left ventricular hypertrophy, J Mol Cell Cardiol. 2012; 52:857. Herrmann J, Kaski JC, Lerman A: Coronary microvascular dysfunction in the clinical setting: From mystery to reality, Eur Heart J. 2012; 33:2771. Lanza GA, Crea F. Primary coronary microvascular dysfunction: Clinical presentation, pathophysiology, and management, Circulation. 2010; 121:2317. Peter Libby, Ira Tabas, Gabrielle Fredman, Edward A. Fisher, Inflammation and its Resolution as Determinants of Acute Coronary Syndromes, Circ Res. 2014;114:1867-1879. Fog Bentzon J, Otsuka F, Virmani R, Falk E. Mechanisms of plaque formation and rupture. Circ Res. 2014; 114:1852–1866. Ley K, Miller YI, Hedrick CC. Monocyte and macrophage dynamics during atherogenesis. Arterioscler Thromb Vasc Biol. 2011; 31:1506–1516. Libby P. Mechanisms of acute coronary syndromes and their implications for therapy. N Engl J Med. 2013; 368:2004–2013. .Steg PG, James SK, Atar D, Badano LP, Blomstrom-Lundqvist C, Borger MA, Di Mario C, Dickstein K, et al, ESC guidelines for the management of acute myocardial infarction in patients presenting with STsegment elevation. Eur Heart J. 2012;33:2569–619 Thygesen K, Alpert JS, Jaffe AS, Simoons ML, Chaitman BR, White HD, et al, Third universal definition of myocardial infarction. Eur Heart J. 2012; 33:2551– 67. Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, et al. 2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/NonSTElevation Myocardial Infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011; 123(18):e426–579. Braunwald E, Morrow DA. Unstable angina: is it time for a requiem? Circulation. 2013;127:2452–7. Anderson JL, Adams CD, Antman EM, Bridges CR, Califf RM, Casey DE Jr, et al. 2011 ACCF/AHA Focused Update Incorporated Into the ACC/AHA 2007 Guidelines for the Management of Patients With Unstable Angina/Non- 92 STElevation Myocardial Infarction: a report of the American College of Cardiology Foundation/American Heart Association Task Force on Practice Guidelines. Circulation. 2011 May 10;123(18):e426–579 Morrow DA, Cannon CP, Rifai N, Frey MJ, Vicari R, Lakkis N, et al, Ability of minor elevations of troponins I and T to predict benefit from an early invasive strategy in patients with unstable angina and non-ST elevation myocardial infarction: results from a randomized trial. JAMA. 2001; 286:2405–12. Reichlin T, Twerenbold R, Reiter M, Steuer S, Bassetti S, Balmelli C, et al. Introduction of high-sensitivity troponin assays: impact on myocardial infarction incidence and prognosis. Am J Med. 2012; 125:1205–13, e1201 Ioannidis JP, Salem D, Chew PW, Lau J. Accuracy of imaging technologies in the diagnosis of acute cardiac ischemia in the emergency department: a metaanalysis. Ann Emerg Med. 2001; 37(5):471–7 Kontos MC, Kurdziel K, McQueen R, Arrowood JA, Jesse RL, Ornato JP, et al. Comparison of 2-dimensional echocardiography and myocardial perfusion imaging for diagnosing myocardial infarction in emergency department patients. Am. Heart J. 2002;143(4):659–67 De Araujo P, Ferreira J, Aguiar C, Seabra-Gomes R. TIMI, PURSUIT, and GRACE risk scores: sustained prognostic value and interaction with revascularization in NSTE-ACS. Eur. Heart J. 2005; 26(9):865–72. Kozieradzka A, Kamiński KA, Maciorkowska D, Olszewska M, Dobrzycki S, Nowak K, et al. GRACE, TIMI, Zwolle and CADILLAC risk scores — Do they predict 5-year outcomes after ST-elevation myocardial infarction treated invasively? International Journal of Cardiology. 2011; 148:70–5 Abu-Assi E, Raposeiras-Roubin S, Lear P, Cabanas-Grandio P, Girondo M, Rodríguez-Cordero M, et al. Comparing the predictive validity of three contemporary bleeding risk scores in acute coronary syndrome. Eur Heart J Acute Cardiovasc Care. 2012;1:222–31. Akkerhuis KM, Klootwijk PA, Lindeboom W, Umans VA, Meij S, Kint PP, Simoons ML. Recurrent ischaemia during continuous multilead ST-segment monitoring identifies patients with acute coronary syndromes at high risk of adverse cardiac events; meta-analysis of three studies involving 995 patients. Eur Heart J. 2001; 22:1997–2006 Schwartz BG, Kloner RA. Drug interactions with phosphodiesterase-5 inhibitors used for the treatment of erectile dysfunction or pulmonary hypertension. Circulation. 2010;122:88–95 Chatterjee S, Chaudhuri D, Vedanthan R, Fuster V, Ibanez B, Bangalore S, Mukherjee D. Early intravenous beta-blockers in patients with acute coronary syndrome—a meta-analysis of randomized trials. Int J Cardiol. 2013; 168:915– 21. 120 Kontos MC, Diercks DB, Ho PM, Wang TY, Chen AY, Roe MT. Treatment and outcomes in patients with myocardial infarction treated with acute beta-blocker therapy: results from the American College of Cardiology’s NCDRw. Am Heart J. 2011; 161:864–70. Berger JS, Stebbins A, Granger CB, Ohman EM, Armstrong PW, Van de Werf F, et al. Initial aspirin dose and outcome among ST-elevation myocardial infarction patients treated with fibrinolytic therapy. Circulation. 2008;117(2):192-9 Bauer T, Bouman HJ, van Werkum JW, Ford NF, ten Berg JM, Taubert D. Impact of CYP2C19 variant genotypes on clinical efficacy of antiplatelet treatment with clopidogrel: systematic review and meta-analysis. BMJ. 2011; 343:d4588. Gurbel PA, Bliden KP, Butler K, Tantry US, Gesheff T, Wei C, et al. Randomized double-blind assessment of the ONSET and OFFSET of the antiplatelet effects of ticagrelor versus clopidogrel in patients with stable coronary artery disease: the ONSET/OFFSET study. Circulation. 2009. Wallentin L, Becker RC, Budaj A, Cannon CP, Emanuelsson H, Held C, et al. Ticagrelor versus clopidogrel in patients with acute coronary syndromes. N Engl J Med. 2009;361(11):1045- 57. 100. Mahaffey KW, W Cannon CP, Harrington RA, James S, Ardissino D, Becker RC, Emanuelsson H, et al. Comparison of ticagrelor with clopidogrel in patients with a planned invasive strategy for acute coronary syndromes (PLATO): a randomised doubleblind study. Lancet. 2010;375(9711):283-93 Harrington RA, Becker RC, Cannon CP, Gutterman D, Lincoff AM, Popma JJ. et al. Antithrombotic therapy for non-ST-segment elevation acute coronary syndromes: American College of Chest Physicians Evidence-Based Clinical Practice Guidelines (8th Edition). Chest 2008;133 Bhatt DL, Scheiman J, Abraham NS, Antman EM, Chan FK, Furberg CD, et al. ACCF/ACG/AHA 2008 expert consensus document on reducing the gastrointestinal risks of antiplatelet therapy and NSAID use. Am J Gastroenterol. 2008;103(11):2890-907 Fox KA, Bassand JP, Mehta SR, Wallentin L, Theroux P, Piegas LS, et al. Influence of renal function on the efficacy and safety of fondaparinux relative to enoxaparin in non ST-segment elevation acute coronary syndromes. Ann Intern Med. 2007; 147(5):304-10. 144 Stone GW, McLaurin BT, Cox DA, Bertrand ME, Lincoff AM, Moses JW, et al. Bivalirudin for patients with acute coronary syndromes. N Engl J Med. 2006; 355(21):2203-16. .Stone GW, Ware JH, Bertrand ME, Lincoff AM, Moses JW, Ohman EM, et al. Antithrombotic strategies in patients with acute coronary syndromes undergoing early invasive management: one-year results from the ACUITY trial. JAMA. 2007; 298(21):2497-506. 155. Hansen ML, Sorensen R, Clausen MT, Fog-Petersen ML, Raunso J, Gadsboll N, Gislason GH, Folke F, Andersen SS, Schramm TK, Abildstrom SZ, Poulsen HE, Kober L, Torp-Pedersen C. Risk of bleeding with single, dual, or triple therapy with warfarin, aspirin, and clopidogrel in patients with atrial fibrillation. Arch Intern Med. 2010;170:1433–4 Eerenberg ES, KamphuisenPW, Sijpkens MK, Meijers JC, Buller HR, Levi M. Reversal of rivaroxaban and dabigatran by prothrombin complex concentrate: a randomized, placebo-controlled, crossover study in healthy subjects. Circulation. 2011; 124:1573–9. Pfeffer MA, Braunwald E, Moye LA, Basta L, Brown EJ, Jr., Cuddy TE, et al. Effect of captopril on mortality and morbidity in patients with left ventricular dysfunction after myocardial infarction. Results of the survival and ventricular enlargement trial. The SAVE Investigators. N Engl J Med. 1992; 327(10): 669- 77. Lubsen J, Tijssen JG. Efficacy of nifedipine and metoprolol in the early treatment of unstable angina in the coronary care unit: findings from the Holland Interuniversity Nifedipine/ metoprolol Trial (HINT). Am J Cardiol. 1987; 60(2):18A-25A. Wood D, De Backer G, Faergemann O, Graham I, Mancia G, Mancia G on behalf of the Task Force Prevention of coronary heart disease in clinical practice. Recommendation of the Second Joint task Force of European and Societies on coronary prevention. Eur Heart J. 1998; 19: 1434-503. |
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Peter Libby, Tratado De Cardiología, Texto De Medicina Cardiovascular, biología vascular de la ateroesclerosis, 10 ed. Volumen 1, El sevier, 41:873-886, 2016. |
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Cano Rivera, RodolfoIglesias Acosta, JesúsAcosta Ariza, María AngélicaRomo Escorcia, Fabio CamiloBarranquilla2017-07-26T19:41:20Z2017-07-26T19:41:20Z2016https://hdl.handle.net/10901/10239instname:Universidad Librereponame:Repositorio Institucional Universidad LibreLos síndromes coronarios agudos son un problema mayor de salud pública en todo el mundo. El síndrome coronario agudo (SCA) incluye infarto agudo de miocardio (IAM), con o sin elevación del ST y la angina inestable. La incidencia anual de IAM sin elevación del segmento ST es 565.000 nuevos eventos y 300.000 ataques recurrentes cada año. Los factores de riesgo para presentar síndromes coronarios agudos incluyen: tabaquismo, niveles elevados de lípidos séricos, hipertensión arterial, diabetes mellitus, obesidad mórbida, sedentarismo, bajo consumo diario de frutas y vegetales, consumo problemático de alcohol e índice psicosocial. La evaluación inicial de un SCA SEST debe enfocarse en el dolor torácico, signos y síntomas asociados y factores de riesgo para SCA. Los marcadores biológicos de lesión miocárdica han evolucionado en la actualidad para una mejor precisión del abordaje diagnóstico y aportan datos para el pronóstico de los pacientes. El manejo actual de las nuevas drogas utilizadas mejora el pronóstico, disminuyen la mortalidad y mejoran la calidad de vida de los pacientes. Esta revisión bibliográfica se realizó con el propósito de actualizar los conocimientos sobre la fisiopatología el diagnóstico y el tratamiento del síndrome coronario agudo sin elevación del ST.PDFapplication/pdfspahttp://creativecommons.org/licenses/by-nc-nd/2.5/co/Atribución-NoComercial-SinDerivadas 2.5 Colombiainfo:eu-repo/semantics/openAccesshttp://purl.org/coar/access_right/c_abf2Síndrome coronario agudoSalud públicaInfarto agudo de miocardioENFERMEDAD CORONARIASíndromes coronarios agudosEpidemiologíaDiagnósticoEnfoque actual del tratamiento farmacológico del síndrome coronario agudo sin elevación del segmento st. de la fisiopatología al manejoTesis de Especializacióninfo:eu-repo/semantics/acceptedVersionhttp://purl.org/coar/resource_type/c_7a1finfo:eu-repo/semantics/bachelorThesisRobert P. Giugliano, Christopher P. Cannon y Eugene Braunwald, Tratado De Cardiología, Texto De Medicina Cardiovascular, Síndromes Coronarios Agudos Sin Elevación Del ST, 10 ed. Volumen 1, El sevier. 2016; 53: 1155- 1181.Lozano R, Naghavi M, Foreman K. Global and regional mortality from 235 causes of death for 20 age groups in 1990 and 2010, The Lancet. 2012; 380:2095.Allan A. World Health Organization. Global status report on non-communicable diseases 2011. [Fecha de consulta: 25 de abril de 2016]. Disponible en: http://www.who.int/nmh/publications/ncd_report2010/es/.Cubillos LA, Casas JP, Morillo C, Bautista LE. Congestive heart failure in Latin America: the next epidemic Am Heart J 2004; 147:412–7.Mack M, Gopal A, Ambarish Gopal, Epidemiology, Traditional and Novel Risk Factors in Coronary Artery Disease, Cardiol Clin 32 (2014) 323–332Abegunde DO, Mathers CD, Adam T, Ortegon M, Strong K. The burden and costs of chronic diseases in low-income and middle-income countries. Lancet. 2007; 370:1929-38.Stamler J, Stamler R, Neaton JD. Low riskfactor profile and long-term cardiovascular and noncardiovascular mortality and life expectancy: findings for 5 large cohorts of young adult and middle-aged men and women. JAMA. 2012; 1999:282Lloyd-Jones DM, Hong Y, Labarthe D. Defining and setting national goals for cardiovascular health promotion and disease reduction: the American Heart Association’s Strategic Impact Goal Through 2020 And Beyond. Circulation 2010; 121:586.Sarwar N, Butterworth AS, Freitag DF. IL6R Genetics Consortium Emerging Risk Factors Collaboration, Interleukin-6 receptor pathway in coronary heart disease: a collaborative metaanalysis of 82 studies. Lancet 2012; 379:1205.Karakas M, Koenig W, Zierer A. Myeloperoxidase is associated with incident coronary heart disease independently of traditional risk factors: results from the MONICA/KORA Augsburg study. J Intern Med 2012; 271:43.Kamin DS, Grinspoon SK. Cardiovascular disease in HIV-positive patients. AIDS 2005; 19:641.Roberts R, Steward AF. Genes and coronary artery disease: where are we? J Am Coll Cardiol 2012; 18:1715–21.ohn M. Canty y Dirk J. Duncker, Tratado De Cardiología, Texto De Medicina Cardiovascular, Flujo Sanguíneo Coronario E Isquemia Miocardica, 10 ed. Volumen 1, El sevier, 2016; 49: 1029-1055.Liu Y, Gutterman DD: Vascular Control In Humans: Focus On The Coronary Microcirculation, Basic Res Cardiol. 2009; 104:211.Beyer AM, Gutterman DD: Regulation of the human coronary microcirculation, J Mol Cell Cardiol. 2012; 52:814Zhang C, Rogers PA, Merkus D, et al: Regulation of coronary microvascular resistance in health and disease. In Tuma RF, Duran WN, Ley K, editors: Microcirculation, Boston, 2008, Elsevier, p 521.Deussen A, Ohanyan V, Jannasch A. Mechanisms of metabolic coronary flow regulation, J Mol Cell Cardiol. 2012; 52:794.Allam A, Thompson R. Atheroesclerosis In Ancient Egyptian Mummies, J am Coll Cardiol Img. 2011; 4 (4):315-327.Chopra H.K, Nanda N. 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