Bridging the practice chasm

Abstract

This editorial refers to ‘The clinical characteristics and investigations planned in patients with stable angina presenting to cardiologists in Europe: from the Euro Heart Survey of Stable Angina’† by C.A. Daly et al. , on page 996, and ‘The initial management of stable angina in Europe, from the Euro Heart Survey. A description of pharmacological management and revascularization strategies initiated within the first month of presentation to a cardiologist in the Euro Heart Survey of Stable Angina’‡ by C.A. Daly et al. , on page 1011 Since the description of angina by Herberden in 1768, the management of patients with angina has improved significantly. Over the past decades, several novel diagnostic and therapeutic techniques have provided better means of detection and treatment. Even with these favourable innovations, numerous studies have consistently demonstrated a wide discrepancy between knowledge and practice. Under-treatment of patients with acute coronary syndromes has been documented in the countries of North America,1,2 Europe,3 and around the world.4 Unlike the commercialization of other technological devices, the introduction of medical products requires a long and arduous process of pre-clinical and clinical studies. On the basis of these results, a panel of eminent specialists in the field, gathered by reputable medical organizations, develops guidelines to assist clinicians in the management of these conditions. Generally, this information is disseminated through international scientific meetings and key medical journals. Notwithstanding the extensive efforts in this exercise, Daly et al. … *Corresponding author. Tel: +65 6476 0880; fax: +65 6475 0880. E-mail address : makkh001{at}yahoo.com