1,720,963 research outputs found
[Indications for statin therapy in patients with acute coronary syndrome of ischemic origin]
No full textRecent evidence has increasingly demonstrated that statins, besides reducing cholesterol levels, are as effective as other therapeutic approaches in the treatment of patients with acute coronary syndromes. Appropriate control of cardiovascular risk factors accounts for 44% of the overall reduction in mortality. The decrease in plasma cholesterol concentrations, however, remains the most effective therapeutic target, leading to a -24% reduction of total mortality. Statins have proved to be effective within the first few weeks after an acute coronary event. As a consequence, their use is recommended by current guidelines (class IB) in patients with non-ST-elevation myocardial infarction. Data from recent trials suggest that early statin therapy is a reasonable option for patients with ST-elevation myocardial infarction (class IA recommendation)
Effects of Rosuvastatin vs. Atorvastatin at high doses acutely after STEMI: endothelial dysfunction and inflammatory biomarkers evaluation
No full textEffect of High dose of atorvastatin versus moderate dose on endothelial function and inflammatory biomarkers in patients with STEMI
No full textEffect of High dose of atorvastatin versus moderate dose on endothelial function and inflammatory biomarkers in patients with STEMI
No full text[New pharmacological approaches to ischemic heart disease]
No full textMajor steps have been made in the treatment of ischemic heart disease from the discovery of nitrates as antianginal medication to the techniques of percutaneous angioplasty. This incredible therapeutic progress has resulted in a reduced incidence of ischemic heart disease and related mortality and morbidity. However, statistical and epidemiological data indicate that in ischemic heart disease, despite the achievement of great success, there is a necessity for a further step toward treatment, considering the fact that the characteristics of this population are changing (increased prevalence of subendocardial infarction compared with classic transmural infarction, especially in the elderly population). Furthermore, the need for alternative therapeutic approaches to traditional ones is recognized. Ranolazine is a selective inhibitor of Na channels that prevents pathological extension of late Na current developing in the ischemic myocardial cell. This current is responsible for calcium overload, with consequent impairment of diastolic relaxation. Ranolazine reduces Na overload induced by calcium and improves diastolic relaxation and coronary subendocardial flow, without affecting hemodynamic parameters such as blood pressure, heart rate, or inotropic state of the heart, avoiding undesirable side effects. Efficacy of ranolazine has been evaluated in several trials, using clinical and instrumental endpoints (MARISA and CARISA) or, more recently, using endpoints such as mortality and reinfarction (ERICA and MERLIN-TIMI 36). Ivabradine acts through the inhibition of late Na current (also known as If), which controls the spontaneous diastolic depolarization of sinus node cells. The partial inhibition of these channels reduces the frequency of sinus node action potential initiation, resulting in decreased heart rate without effects on contractility, atrio-ventricular conduction, or repolarization. The BEAUTIFUL trial has tested whether the effect of ivabradine in lowering heart rate is able to reduce mortality and cardiovascular morbidity in patients with coronary artery disease and left ventricular systolic dysfunction. The most significant results were obtained in the subgroup of patients with life-limiting exertional angina. In this group, ivabradine significantly reduced the primary endpoint, a composite of cardiovascular death, hospitalization for fatal and nonfatal acute myocardial infarction (AMI) or heart failure, by 24%, and hospitalizations for AMI by 42%. In the subgroup of patients with baseline heart rate >70 bpm, hospitalizations for AMI and revascularization were reduced by 73% and 59%, respectively
Efficacy of a combination of natural lipid-lowering and antioxidant agents in hypercholesterolaemic patients
No full textEmbolia polmonare e sindromi coronariche acute: l'importanza di decisioni diagnostico-terapeutiche in urgenza e la consapevolezza di incidere sulla vita di due soggetti
No full textEfficacia della terapia con atorvastatina sui markers di stress ossidativo in pazienti con STEMI sottoposti a PTCA primaria
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