{"id":20126,"date":"2017-12-11T15:13:26","date_gmt":"2017-12-11T14:13:26","guid":{"rendered":"https:\/\/hellocare.com\/?p=20126"},"modified":"2025-12-05T10:10:37","modified_gmt":"2025-12-05T09:10:37","slug":"angine-de-poitrine","status":"publish","type":"post","link":"https:\/\/www.hellocare.com\/blog\/angine-de-poitrine\/","title":{"rendered":"Angine de poitrine : la pose de stents est-elle obligatoire ?"},"content":{"rendered":"

Par L\u00e9a Maggiore, M\u00e9decin G\u00e9n\u00e9raliste<\/em><\/p>\n<\/div>

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U<\/span>ne \u00e9tude publi\u00e9e dans le c\u00e9l\u00e8bre journal m\u00e9dical \u201cthe lancet\u201d la semaine derni\u00e8re, repris avec fracas par les m\u00e9dias, questionne la pose de stent syst\u00e9matique lors de l\u2019angor stable. Une \u00e9tude faite sur une population limit\u00e9e, 230 personnes, qui reste donc \u00e0 confirmer.<\/span><\/span><\/p>\n<\/div>

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\"angine<\/span><\/div>
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L’angine de poitrine<\/h2><\/h2><\/div>
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Appel\u00e9e aussi <\/span>angor stable<\/strong>, il s\u2019agit d\u2019une douleur thoracique lors de l\u2019effort provoqu\u00e9e par le r\u00e9tr\u00e9cissement des art\u00e8res irriguant le c\u0153ur (art\u00e8res coronaires), partiellement bouch\u00e9es par des plaques d\u2019ath\u00e9rome. La douleur est due au d\u00e9ficit d\u2019apport en oxyg\u00e8ne au c\u0153ur compar\u00e9e \u00e0 ses besoins \u00e0 l\u2019effort. C\u2019est une douleur qui c\u00e8de 5 minutes apr\u00e8s arr\u00eat de l\u2019effort.<\/span><\/p>\n<\/div>\n<\/div>\n

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Cette maladie est d\u00fb le plus souvent \u00e0\u00a0des mauvaises habitudes de vie<\/strong>\u00a0: tabac, alcool, alimentation transform\u00e9e, s\u00e9dentarit\u00e9, stress, bien que chez certaines personnes, aucun facteur de risque ne soit retrouv\u00e9.<\/p>\n

Le plus grand risque de cette maladie est la survenue d\u2019un\u00a0infarctus<\/strong>\u00a0(douleur thoracique ne c\u00e9dant pas \u00e0 l\u2019arr\u00eat de l\u2019effort). Quand la maladie est d\u00e9tect\u00e9e, les cardiologues mettent en place des traitements m\u00e9dicamenteux maintenant tr\u00e8s efficaces.<\/p>\n

Il est aussi propos\u00e9 de mettre des stents, petits ressorts introduits \u00e0 l\u2019aide d\u2019une sonde par l\u2019art\u00e8re f\u00e9morale au niveau de la jambe qui remonte jusque dans le coeur par la circulation sanguine. La pose de ces stents est tr\u00e8s courante et fait partie de la prise en charge classique des angors de poitrine. On pose a peu pr\u00e8s 120 000 stents par an en France (infarctus et angor compris) avec un co\u00fbt compris entre 3000 et 14000 euros.<\/p>\n

Parce qu\u2019ils soulagent la douleur, et sont moins invasifs que la chirurgie, ils sont devenus le traitement de choix. M\u00e9decins et patients ont commenc\u00e9 \u00e0 croire qu\u2019en les posant chez des patients avec angor stable, ils sauvaient des vies.<\/p>\n<\/div>\n<\/div>\n

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Faut-il une pause syst\u00e9matique du stent ?<\/h3>\n<\/div>\n<\/div>\n
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Les cardiologues de L\u2019imperial college of London ont donc r\u00e9alis\u00e9 une \u00e9tude comme on r\u00e9alise pour la validation des m\u00e9dicaments, c\u2019est-\u00e0-dire qu\u2019ils ont pris des patients souffrant d\u2019angor et les ont s\u00e9par\u00e9s en deux groupes. Les 2 groupes sont emmen\u00e9s en salle de cath\u00e9t\u00e9risme, un groupe subissant la mont\u00e9e de la sonde dans le coeur avec pose de stent et l\u2019autre groupe ne subissant que la mont\u00e9e de la sonde sans pose de stents. Pendant les six semaines qui ont suivi, tous les patients ont re\u00e7u un traitement m\u00e9dicamenteux. R\u00e9sultats : avec ou sans stent, les patients avaient moins de douleurs et de meilleurs r\u00e9sultats \u00e0 l\u2019effort 6 semaines apr\u00e8s l\u2019intervention.<\/p>\n

\u00abDe fa\u00e7on surprenante, m\u00eame si la pose de stent a fluidifi\u00e9 la circulation sanguine, elle n\u2019a pas am\u00e9lior\u00e9 le ressenti des sympt\u00f4mes par rapport aux m\u00e9dicaments\u00bb, a expliqu\u00e9 le Dr Rasha al-Lamee, cardiologue \u00e0 l\u2019Imperial College London et premi\u00e8re auteure de l\u2019\u00e9tude\u00a01<\/sup>
\nIl faut reconnaitre que c\u2019est une \u00e9tude int\u00e9ressante mais qu\u2019il n\u2019y a pas de diff\u00e9rence significative dit le Pr Steg dans lib\u00e9ration1<\/sup>. Il faut attendre une \u00e9tude \u00e0 plus grande \u00e9chelle, qui portera sur 4000 patients dont les r\u00e9sultats sortiront fin 2018.<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n

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Alors comment fortifier son coeur ?<\/h3>\n<\/div>\n<\/div>\n
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Alors si l\u2019on doute de l\u2019efficacit\u00e9 des stents sur l\u2019angor stable, que peut-on proposer aux patients ?<\/p>\n

Il reste certain que l\u2019am\u00e9lioration de la qualit\u00e9 de vie passe par une modification du mode de vie. En effet, la\u00a0m\u00e9ta-analyse de Meier<\/a>\u00a02\u00a0<\/sup>publi\u00e9e en septembre 2011 dans le journal de la Soci\u00e9t\u00e9 europ\u00e9enne de cardiologie a montr\u00e9 que le d\u00e9veloppement d\u2019un r\u00e9seau d\u2019art\u00e8res collat\u00e9ral important diminue le risque d\u2019infarctus et de d\u00e9c\u00e8s cardiaque.<\/p>\n

Comment proc\u00e9der ? En faisant du\u00a0sport<\/a>, plus exactement 20 minutes de cardio mod\u00e9r\u00e9 (le v\u00e9lo par exemple) par jour !
\nEt bien s\u00fbr\u00a0manger vari\u00e9, \u00e9quilibr\u00e9, de saison<\/a>, et ayez un\u00a0sommeil<\/a>\u00a0de qualit\u00e9 !<\/p>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>\n<\/div>

Sources<\/em><\/h5>\n

1 :\u00a0http:\/\/www.liberation.fr\/france\/2017\/11\/08\/angine-de-poitrine-la-pose-de-stents-est-elle-incontournable_1608691<\/a><\/em><\/p>\n

2 : https:\/\/www.ncbi.nlm.nih.gov\/pubmed\/22720974<\/em><\/p>\n<\/div>

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> Pour levez le doute sur votre \u00e9tat de sant\u00e9, parlez \u00e0 un m\u00e9decin sans rdv<\/a><\/em><\/p>\n<\/div>

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\"consulter<\/a><\/span><\/div>
<\/div><\/div><\/div><\/div><\/div><\/p>\n","protected":false},"excerpt":{"rendered":"

ne \u00e9tude publi\u00e9e dans le c\u00e9l\u00e8bre journal m\u00e9dical \u201cthe lancet\u201d la semaine derni\u00e8re, repris avec fracas par les<\/p>\n","protected":false},"author":28,"featured_media":24218,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"inline_featured_image":false,"footnotes":""},"categories":[575],"tags":[],"class_list":["post-20126","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-sante-generale-medecine"],"acf":[],"yoast_head":"\nAngine de poitrine : la pose de stents est-elle obligatoire ?<\/title>\n<meta name=\"description\" content=\"Angine de poitrine ou angor stable : faut il vraiment r\u00e9aliser une pose de stent ? 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