Modern cardiology has given up on curing heart disease. Its aggressive interventions-- coronary artery bypass graft, atherectomy, angioplasty, and stenting--do not reduce the frequency of new heart attacks or prolong survival except in small subsets of pa
it may no longer be enough to measure just HDL levels without determining levels of paroxonase and platelet-activating acetylhydrolase; levels of these enzymes may determine whether HDL is proinflammatory or protective. Likewise, measuring Lp(a) and small
For "traditional" cardiologists, CAD is a blockage or blockages in the coronary arteries, and the treatment is stents. For "nontraditional" cardiologists, CAD is a more systemic, diffuse condition, and the treatment is systemic.
Women and Heart Disease The Role of Diabetes and Hyperglycemia Elizabeth Barrett-Connor, MD; Elsa-Grace V. Giardina, MD; Anselm K. Gitt, MD; Uwe Gudat, MD; Helmut O. Steinberg, MD; Diethelm Tschoepe, MD Arch Intern Med. 2004;164:934-942.
Overweight men and women assigned to drink fructose-sweetened beverages as 25% of their energy intake developed atherogenic lipid profiles in just two weeks; unlike glucose, fructose promotedatherogenic lioproprotein phenotypes and glucose intolerance/ins
The morbidity, mortality, expense and transient benefits of a high technology approach toward the coronary disease epidemic, has failed. It is time to realize that the answer to a faulty lifestyle epidemic is not drugs and technology – it is lifestyle.
Our patient exemplified the challenges involved in a CTO, which included the length of the lesion, the lack of a proximal nipple, the presence of a side branch at the occlusion point, poor visualization of the distal vessel despite contralateral injection
Finnish Medical Society Duodecim. Unstable angina pectoris. In: EBM Guidelines. Evidence-Based Medicine [CD-ROM]. Helsinki, Finland: Duodecim Medical Publications Ltd.; 2006 Mar 15 [Various]
Third Joint Task Force of European and other Societies on Cardiovascular Disease Prevention in Clinical Practice (constituted by representatives of eight societies and by invited experts).
Elevated levels of myeloperoxidase in otherwise healthy men and women increased the likelihood of overt coronary artery disease by 50% over 8 years compared with patients who had the lowest levels of the enzyme (P<0.001), according to a 2007 report publis
An unreasonable gap exists between medical enthusiasm devoted to acute interventions and meager efforts devoted to secondary prevention. Rene C. Favaloro, MD, Pioneer of Coronary Artery Bypass Graft Surgery
From hs-CRP results, doctors gain crucial insight into inflammation of the blood vessels around the heart, a factor not considered until now for patients at risk.
In much of the world (but not in the U.S.,) drug-coated stents are avoided by cardiologists because of their high cost. To compensate for the inability to use these stents, many cardiologists outside of the U.S. have taken to administering sirolimus (also
In the Injury Theory, it's damage to the arterial endothelium, followed by platelet activation, then smooth muscle cell migration to injury, then macrophages, with resulting "foam cells." Engorged foam cells burst, starting the injury cycle all over again
Electron Beam CT, or EBCT scans (formerly called ultrafast CT scans) are useful in detecting the presence of calcium deposits in the lining of the coronary arteries. The presence of calcium deposits is a strong indicator that coronary artery disease is al
Surgery does not deal with the basic molecular foundation of disease. It is a mechanical approach to a biologic problem. For those of us who are considered experts in the areas of coronary disease, what an embarrassment to admit that coronary artery disea
elective PTCA of totally occluded coronary arteries is feasible but the primary success rate is lower (57%) than that associated with conventional lesions. The long-term clinical results following successful angioplasty are satisfactory (64%), but the inc
After adjusting for other risk factors impaired fasting glucose was associated with a 2.5-fold increase in the risk of a fatal cardiac event within five years (hazard ratio 2.5, 95% CI 1.2-5.1), said Elizabeth L.M. Barr, M.P.H., of the International Diabe
Two Swiss meta-analyses have found an increased rate of myocardial infarction and death with the Cypher (sirolimus-eluting) coronary stent, which is likely to put a serious chill in interventional cardiology's infatuation with drug-coated devices