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Sholter D E - - 2000
OBJECTIVE: To review the potential adverse effects of glucocorticoid therapy on the cardiovascular system and to provide insight into the mechanisms of these effects. DATA SOURCES: Case reports and studies demonstrating adverse effects of glucocorticoid therapy on the cardiovascular system were examined from a MEDLINE search. Animal data and in ...
Muhlestin J B - - 2000
The major cause of morbidity and mortality associated with coronary atherosclerosis is plaque rupture, which often results in one of the acute coronary syndromes: unstable angina, non-Q-wave myocardial infarction (MI), or Q-wave MI. Plaque rupture may be attributable to the thickness of the overlying fibrous cap; thinner plaques are more ...
Rosenson R S - - 2000
Cholesterol-lowering therapy has not been considered an important risk factor for stroke; however, lipid-lowering therapies reduce cerebrovascular events in patients with coronary heart disease (CHD). The basic mechanisms of cerebrovascular protection have emphasized reduced atheroemboli from the left ventricle and aortic arch, delayed carotid artery disease progression, stabilization of vulnerable ...
Rockson S G - - 2000
Coronary heart disease remains the leading cause of death in the United States. Although coronary heart disease and stroke entail very expensive therapies and extensive hospital utilization, the cost of preventive measures is also quite expensive. In this review, the factors that determine the cost-effectiveness of statin therapy for the ...
Hamasaki S - - 2000
Coronary vascular remodeling and altered endothelial function have been described in the early stages of native atherosclerosis. The purpose of this study was to evaluate the association between cholesterol-lowering therapy and coronary vascular remodeling and endothelial function in patients with normal or mildly diseases coronary arteries. Patients (N=101) with normal ...
Grundy S M - - 2000
Several large controlled clinical trials have documented that cholesterol lowering causes a marked reduction in major coronary events in patients with established coronary heart disease. Cholesterol lowering thus joins other proven therapies for risk reduction in secondary prevention. The need to include cholesterol-lowering therapy in secondary prevention has been endorsed ...
Birtcher K K - - 2000
A multidisciplinary program was designed to improve patient outcomes after an acute coronary event. The primary objective of the program was that lipid-lowering therapy be prescribed at the time of discharge for acute myocardial infarction (AMI) and percutaneous transluminal coronary angioplasty (PTCA) patients. Secondary objectives for this program were (1) ...
Merenich J A - - 2000
Rocky Mountain Kaiser Permanente has taken aggressive steps to ensure optimal treatment of all modifiable cardiac risk factors, especially low-density lipoprotein (LDL) cholesterol, in patients with coronary artery disease. In this article, we are presenting (1) the basic rationale for our approach, (2) the critical steps translating philosophy into practice, ...
Evans R D - - 2000
The isolated perfused heart preparation is an invaluable model for investigating metabolism in a variety of physiological and pathological states. It avoids confounding systemic factors (e.g. endocrine, metabolic and work load changes) and permits simultaneous measurement of mechanical function. The ability to measure arteriovenous concentration differences across the myocardium and ...
Marian A J - - 2000
OBJECTIVES: Our objectives were to determine whether angiotensin-1 converting enzyme (ACE) insertion/deletion (I/D) polymorphism was associated with the severity of coronary artery disease (CAD) and its progression/regression in response to fluvastatin therapy in the Lipoprotein and Coronary Atherosclerosis Study (LCAS) population. BACKGROUND: Genetic factors are involved in susceptibility to CAD. ...
Budoff M J - - 2000
Over 50% of myocardial infarctions lead to sudden death without any prior warning signs or previously known coronary disease (1). Thus, persons with preclinical atherosclerosis must be identified prior to the onset of angina, MI, stroke or death. It has been estimated that primary prevention can avert more than 100,000 ...
Greco K - - 2000
Coronary artery disease (CAD) is one of the leading causes of death in the United States. Eighty percent of people having heart attacks have normal cholesterol levels. A quarter of the population have a condition called low-density lipoprotein (LDL) pattern B that has been associated with a threefold risk of ...
Kes P - - 2000
The end-stage renal disease (ESRD) population experiences an excess morbidity and mortality due to arteriosclerotic cardiovascular disease (CVD) outcomes. Specifically, event rates for myocardial infarction and stroke are 5- to 10-fold in ESRD patients on maintenance dialysis than in the general population. Recently, there is controlled evidence that hyperhomocysteinemia occurs ...
Waters D D - - 2000
Although previous studies have shown that angioplasty improves exercise performance and reduces symptoms better than standard medical therapy in low risk, stable patients with coronary disease, none of these studies used aggressive cholesterol-lowering medical therapy. In addition, the event rate of death from myocardial infarction and other coronary events was ...
Mostaza J M - - 2000
OBJECTIVES: We sought to evaluate whether pravastatin treatment increases myocardial perfusion, as assessed by thallium-201 single-photon emission computed tomographic (SPECT) dipyridamole testing, in patients with coronary artery disease (CAD) and average cholesterol levels. BACKGROUND: Previous studies in hypercholesterolemic patients have demonstrated that cholesterol reduction restores peripheral and coronary endothelium-dependent vasodilation ...
Erkkilä A T - - 2000
Autoantibodies against oxidized low density lipoprotein (oxLDL) have been proposed to be independent predictors of atherosclerotic vascular disease. Because the levels of autoantibodies against oxLDL and cardiolipin might be modified by the presentation and severity of coronary heart disease (CHD), we measured their levels in patients with different manifestations of ...
- - 2000
The Kyushu Lipid Intervention Study (KLIS) aimed to investigate the effects of pravastatin in the primary prevention of coronary events and cerebral infarction in Japanese men aged 45-74 years with serum total cholesterol of > or = 220 mg/dl (5.69 mmol/l). The coronary events included myocardial infarction, coronary artery surgery ...
Bybee K A - - 2000
Patients with known coronary artery disease frequently change their lifestyles (e.g., diet, exercise, and smoking habit) after the diagnosis is made. Such changes can alter lipid risk factor levels and obscure etiologic risk factor associations with the presence of coronary artery disease. It is therefore preferable to determine the contribution ...
Enbergs A - - 2000
BACKGROUND: The prevalence of coronary vessel wall alterations in the general population is not known. Therefore, the aim of our study was to determine the prevalence of coronary artery disease in persons in whom the underlying disease was not related to coronary artery disease and could therefore be regarded as ...
Ekmekcioglu C - - 2000
The present study was designed to investigate whether oxidized low-density lipoprotein is accumulated in the left and right ventricular walls of patients with coronary heart disease (n=10) compared with patients with dilated cardiomyopathy (n=9) or healthy heart donors (controls, n=5). Sections from both ventricles of explanted hearts and coronary arteries ...
Uehara Y - - 2000
Apart from ACE, various angiotensin II (Ang II)-forming serine proteinases (eg, chymase, kallikrein, and cathepsin G) are known to exist in human tissues, but their clinical significance or the regulatory mechanisms that control their activities are not well established. A recent clinical study has shown that chymase activity was significantly ...
Attebring M F - - 2000
This study evaluates the occurrence of various risk indicators, with particular emphasis on serum lipids one year after a coronary event (development of acute mycoardial infarction (AMI); exposure to either coronary artery bypass grafting (CABG) or percutaneous transluminal coronary angioplasty (PTCA), prior to and after presentation of the main results ...
Vuorio A F - - 1999
Familial hypercholesterolemia (FH) is among the most common single-gene diseases and is due to mutations of the low-density lipoprotein (LDL) receptor gene. In heterozygous FH, serum LDL-cholesterol level is elevated two- to threefold compared to unaffected individuals, men in particular are prone to premature atherosclerosis and early cardiac deaths. However, ...
Archbold R A - - 1999
Large randomized placebo-controlled trials have demonstrated that cholesterol lowering with statin therapy reduces the incidence of adverse cardiac events. Smaller angiographic studies have shown that coronary artery disease progression can be slowed and, in some cases, reversed by cholesterol-lowering interventions. These anatomical changes, however, are small and occur too slowly ...
Järvisalo M J - - 1999
Inhibitors of 3-hydroxy-3-methylglutaryl coenzyme A (HMG CoA) reductase (statins) may enhance vascular endothelial function independent of their cholesterol lowering effect. To test this hypothesis, we surveyed two groups of patients (age 55+/-7, mean+/-SD) with coronary artery disease that were matched for age, blood pressure and serum lipid levels. Group 1 ...
Stavenow L - - 1999
OBJECTIVE: To study the influence of different levels of serum (s)-triglycerides in relation to s-cholesterol on the risk of myocardial infarction. DESIGN AND SUBJECTS: A 6-13 (mean 10) year follow-up of 12,510 middle-aged men. Fasting s-triglycerides and s-cholesterol were measured at the screening examination. SETTING: Section of Preventive Medicine at ...
Fuster V - - 1999
This presentation describes the atherothrombotic processes leading to acute coronary syndromes based on the recent studies of vascular biology. It outlines the mechanism of action and the evolving impact of lipid-lowering therapy in stabilization and secondary prevention of such processes. The present understanding of the pathogenesis of each phase of ...
Steinberg D D Department of Medicine, University of California, San Diego, - - 1999
In the more than 50 years since the founding of the National Heart, Lung, and Blood Institute and the American Heart Association, medical science has moved from an era in which hypercholesterolemia, as it is now defined, was not believed to be abnormal to one in which controlling hypercholesterolemia is ...
Aksoy M - - 1999
Previous studies have reported that high serum lipoprotein(a) levels may be responsible for total occlusion of the infarct-related artery via inhibition of intrinsic fibrinolysis during acute myocardial infarction. We evaluated whether this would result in a greater extent of myocardial necrosis and impaired left ventricular function in patients with high ...
Girod W G - - 1999
Hypercholesterolemia is a primary risk factor for atherosclerosis, coronary artery disease, and myocardial infarction. We subjected low density lipoprotein receptor-deficient (LDLr -/-) and control (wild-type) mice to 30 minutes of myocardial ischemia and 120 minutes of reperfusion. Myocardial infarction per area at risk (AAR) was noted under baseline conditions to ...
Kajinami K - - 1999
The efficacy and safety of the therapeutic tool which directly removes LDL particles from circulation (LDL apheresis) has already been established for cholesterol-lowering in patients with refractory hypercholesterolemia, such as homozygous familial hypercholesterolemia. Several angiographic studies have demonstrated that regular LDL apheresis therapy had favorable effects on the progression of ...
Lomar AV - - 1999
We describe the case of a young HIV-positive patient undergoing three-drug antiretroviral therapy that included a protease inhibitor for 9 months, who was admitted to the hospital with an acute myocardial infarction. A coronary angiogram revealed occlusion caused by a thrombus in the proximal third of the anterior descending artery. ...
Tataru M C - - 1999
BACKGROUND: Plasma concentrations of D-dimers show the extent of intravascular fibrinolysis of cross-linked fibrin. Higher concentrations of D-dimers are found in the plasma of arteriosclerosis patients with increased fibrin metabolism. The present study was performed in order to investigate whether there is a relationship between the severity of arteriosclerosis and ...
Yeo K R - - 1999
To investigate whether an interaction between diltiazem and the 3-hydroxy-3-methylglutaryl coenzyme A (HMG-CoA) reductase inhibitor simvastatin may enhance the cholesterol-lowering response to simvastatin in diltiazem-treated patients. One hundred and thirty-five patients attending the Sheffield hypertension clinic who started consecutively on simvastatin for primary or secondary prevention of coronary heart disease ...
Möhlenkamp S S Department of Physiology and Biophysics, Mayo Clinic Rochester, MN 55905, - - 1999
An asymptomatic 36-year-old woman had high cholesterol levels due to heterozygous familial hypercholesterolemia (FHC) and a family history of coronary artery disease (CAD) but no other risk factors. Exercise testing showed no signs of ischemia. Conventional drug therapy did not lower lipid levels adequately. However, low-density lipoprotein (LDL) apheresis, which ...
Arntz H R - - 1999
Treatment with HMG-CoA reductase inhibitors (or statins) lowers total and LDL cholesterol and decreases the risk of cardiovascular events. The absolute benefits are greater in patients with a higher baseline cardiovascular risk, so statins are particularly suited to secondary prevention. Although three large studies have shown convincingly that, in patients ...
Vrtovec B - - 1999
BACKGROUND: Although a greater than normal intima-media thickness (IMT) has been found in older coronary patients, the data for younger patients are lacking. OBJECTIVE: To determine the carotid IMT in patients with premature myocardial infarction. METHODS: We measured IMT (common and internal carotid, carotid bifurcation) in 30 coronary patients, aged ...
Vaughan C J - - 1999
BACKGROUND: The atheroma-retarding properties of beta-hydroxy-beta-methylglutaryl coenzyme A reductase (HMG-CoA) inhibitors, or "statins," in both the coronary and carotid arterial beds are well established. However, a growing body of recent data suggests that statins possess important adjunctive properties that may confer additional benefit beyond the retardation of atherosclerosis. In this ...
Wang T D - - 1999
Large-scale clinical trials have shown that long-term treatment with lipid-lowering therapy results in a significant reduction in the occurrence of heart failure among patients with coronary artery disease without previous evidence of congestive heart failure, suggesting dyslipidemia may have an adverse effect on left ventricular performance. To examine whether dyslipidemia ...
Ginsberg H N - - 1999
Recent publications, including new population-based studies and a meta-analysis of prospective, population-based studies, provide strong evidence for an elevated triglyceride level as an independent risk factor for coronary heart disease. Pathophysiologic relationships between elevated triglyceride levels and both reduced high-density lipoprotein levels and an increase in the proportion of low ...
Kinlay S - - 1999
The recent clinical trials of lipid lowering have established the benefit of this therapy in men and women with, or at high risk for, cardiovascular disease. It is now thought that most of the reduction in the risk of clinical events is due to functional rather than anatomic changes in ...
Pasceri V - - 1999
The high frequency of premature atherosclerosis in patients with homocystinuria suggested the hypothesis of an association between hyperhomocysteinemia and coronary heart disease. Experimental studies have shown that severe homocysteinemia has toxic effects on the endothelium and may alter haemostatic balance. Although case controls studies have suggested a significant association between ...
LaRosa J C - - 1999
Coronary artery disease is the most common cause of death in the world. Emerging concepts of atherosclerosis imply that atherosclerosis is a diffuse disease, and cannot be definitively treated with local, anatomic interventions, such as coronary artery bypass graft surgery or angioplasty. Cholesterol lowering, on the other hand, has been ...
Rubins H B - - 1999
BACKGROUND: Although it is generally accepted that lowering elevated serum levels of low-density lipoprotein (LDL) cholesterol in patients with coronary heart disease is beneficial, there are few data to guide decisions about therapy for patients whose primary lipid abnormality is a low level of high-density lipoprotein (HDL) cholesterol. METHODS: We ...
Wong M S - - 1999
Lipoprotein(a) [Lp(a)] is formed when apolipoprotein(a) is linked to low density lipoprotein (LDL)-cholesterol via a single disulfide bond. It is an independent risk factor for myocardial infarction and raised concentrations are associated with an increased risk of developing coronary artery disease. Singapore has a multi-racial population of 77% Chinese, 14% ...
- - 1999
(1) In primary prevention trials, pravastatin and lovastatin prevented myocardial infarction and had a positive risk-benefit ratio in men with LDL-cholesterol values exceeding 4.5 mmol/l (1.7 g/l). Cholestyramine and gemfibrozil also prevented myocardial infarction in men with more severe hypercholesterolaemia; while clofibrate had a negative risk-benefit ratio in patients with ...
Cullen P - - 1999
Calculating a person's chances of developing coronary heart disease (CHD) is not simple, as many risk factors interact in a complex fashion. Thus many markers, though significant in univariate comparisons, are no longer so when multivariate analysis is performed. Those factors contributing independently to risk can be identified only in ...
Pedersen T R - - 1999
Several randomized clinical trials using statins in the prevention of coronary heart disease (CHD) have demonstrated benefit, both in terms of retardation of the progression of signs of coronary atherosclerosis and in reduced morbidity and mortality rates. Three of these trials have examined the long-term effect of statins in patients ...
Pitt B - - 1999
BACKGROUND: Percutaneous coronary revascularization is widely used in improving symptoms and exercise performance in patients with ischemic heart disease and stable angina pectoris. In this study, we compared percutaneous coronary revascularization with lipid-lowering treatment for reducing the incidence of ischemic events. METHODS: We studied 341 patients with stable coronary artery ...
Whitney E - - 1999
Atherosclerotic cardiovascular diseases are the most common causes of death in the United States. Fibrous plaques develop in 77% to 78% of men before age 30. The mean low-density lipoprotein-cholesterol (LDL-C) level in men aged 25 to 30 years is 117 mg/dL. In the Air Force/Texas Coronary Atherosclerosis Prevention Study, ...
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