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Coronary event answers (253)

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Q: 

How soon after stopping simvastatin (due to side-effects) will his risk of a coronary event rise?

A: We were unable to find an evidence based answer to this using Cochrane, Medline or TRIP. We were hopeful of an answer in a review in Bandolier entitled “Statins and the law of unintended consequences” (1) which looked at “two pieces of evidence which imply that stopping or changing statins could increase vascular risk by about three times.” However, we have been unable to access the first piece of evidence, which is an audit published by letter in the Lancet (2), and the second piece of evidence looks at patients who were taking statins before onset of chest pain for whom the statin was discontinued, which seems of limited relevance to your query (3). We found a recent primary study on Medline entitled “Effects of simvastatin withdrawal on serum matrix...
Q: 

What additional benefit does Omacor confer to patients after an acute coronary event when compared with standard therapy

A: The NLH Q&A Service answered a closely related question earlier this year [1] (on post-MI patients) and we recommend you read that via the URL below.  As you will see there is considerably uncertainty and the benefits are not clear, NICE reports[2]:   “The only large trial of supplementation with 1g of omega 3 polyunsaturated fatty acids has shown a reduction in mortality and cardiovascular morbidity, although there was a low uptake to statins and other secondary prevention drugs at baseline in this trial (1++).”   A 2004 review by the American Agency for Healthcare Research and Quality [3] concluded:   “A large, consistent beneficial effect of omega-3 fatty acids was found only for triglyceride levels. Little or no...
Q: 

Are You Aware Tha Elevated Blood Sugar And Severe Stress Are The Real Enemies NOT Cholesterol In coronary?

A: Another small excerpt from "The Great Cholesterol Con" by Anthony Colpo Stress and CHD; More Than Just A Statistical Association "When presented with epidemiological studies linking stress to CHD , are we looking at a causal or merely secondary association? Abundant experimental evidence indicates we are observing a direct association. When psychological stress is induced in volunteers through such activities like frustrating tasks , recalling angry experiences, or public speaking researchers have observed the following *Dilation (widening) of healthy arteries , but constriction of atherosclerotic arteries *Arterial spasm; *Increased blood platelet aggregation; *Increased production of fibronogin, a protein that assists in the formation of blood clots; *Abnormalities...


Q: 

What Are The Risks Of Recurrent Ischaemic events After Myocardial Infarction: Prehospital, At 30 Days And At 1 Year?

A: Data from the WHO MONICA project in 38 populations from 21 countries show that 49% and 54%, respectively, of all men and women with an acute coronary event die within 28 days. About 70% of these deaths occur out of hospital on day 1 and it is generally accepted that a large proportion of these early deaths are the result of ventricular fibrillation. Thus provision of rapid access to a defibrillator remains the single most effective way to save lives in acute coronary syndromes. Following hospital admission the outcome of acute myocardial infarction is determined largely by left ventricular function. Before the introduction of thrombolytic and other reperfusion strategies, average in-hospital mortality from acute...
Q: 

coronary heart disease?

A: 16 Feb 2012 Risk Factors Over the past decades, heart disease rates declined in both men and women as they quit smoking and improved dietary habits. This rate, however, has stabilized in recent years, most likely because of the dramatic increase in obesity in the U.S. and other industrialized nations. Age The risks for coronary artery disease increase with age. About 85% of people who die from heart disease are over the age of 65. Gender Men have a greater risk for coronary artery disease and are more likely to have heart attacks earlier in life than women. Women’s risk for heart disease increases after menopause, and they are more likely to have angina than men. Genetic Factors and Family History Expand this post... Certain genetic...


Q: 

Is There A Role For Prescribing Antioxidant Vitamins To Patients With coronary Artery Disease? If So, Who Should Get Them, And At What Dose?

A: Three large prospective studies have shown that vitamin E users have a 40% lower rate of coronary artery disease. At least 100 IU/day of supplement is required to gain benefit. However, one large study in postmenopausal women showed no benefit from vitamin E supplementation, but high dietary vitamin E consumption reduced the risk by 58%. At present there are only two intervention studies in patients with coronary artery disease available to guide therapeutic decisions. The CHAOS study1 used 400 or 800 IU/day while the ATBC study2 used 50 IU/day. Both studies showed that vitamin E does not save lives in patients with coronary artery disease and that it may increase the number of deaths. Both studies also agree that...
Q: 

events often not aids related?

A: Response from Dr. Wohl Dear Mr. Robertson, It is key, of course, to realize that there has not been a one-to-one swap of AIDS related diseases for treatment related adverse events as a cause of death among persons with HIV/AIDS. Overall, mortality rates are still much less than the era prior to combo therapy. There are several things at play in the results you quote. Foremost, people are living long enough to die of other conditions not directly related to HIV or even HIV therapy. Co-morbid conditions, and hepatitis C in particular, are claiming the lives of many persons with co-infection. In this study, almost half the serious adverse events were liver related and viral hepatitis played a major role. Cardiovascular

Q: 

Is it possible to reduce the extent of calcification in diseased coronary arteries?

A: billyabe,   Thanks for your question.   CAT scans done for calcium scoring detect the amount of calcium which correlates pretty well with the existence and extent of coronary artery disease.  It does not, however, show the anatomy - the location and size of the blockages that are present.  This can only be done by cardiac catheterization. The calcium is located within the plaques, or blockages.    First, you must do everything you can to stop the progression of the disease process.  Though you can''t change your genetic predisposition, there are many things you can do about other risk factors that you have.   You have to make major lifestyle changes.  You must cut the alcohol intake to no more than two...
Q: 

In a 62 year old lady who had acute coronary syndrome who had a stent inserted after an angiogram,is there any rationale for performing and exercise tolerance test 3months later?

A: A recent article in BMC Cardiovascular Disorders [1] concluded:   “Although the statistical power of the study was limited by the small number of clinical events (particularly MI and death), the results of this study support the ACC/AHA guidelines that exercise treadmill testing should not be used routinely after PCI.”   The background to the article reports:   “Over one million percutaneous coronary interventions (PCI) are performed worldwide annually. The rate of restenosis is between 30–40% following balloon angioplasty and 20–30% following stenting with bare metal stents, and   For interest the ACC/AHA guidelines can be viewed via the URL below [2]   We also found a number of older...
Q: 

coronary Artery Spasm

A: Hi BBP, My cardiologist believes that I have coronary artery spasms also. I am on a low dose norvasc. I can''t really say that it controls them if that is what I have. They simple come and go as they please. However I do not have attacks as bad as you.. When I have them, they are more sharp than dull and crushing. They do not last long but come back for a few hours. Mine are definately triggered by very stressful events such as my daughter being ill and hospital. Then they will just take off and I will have them daily for months. The ''warm rush'' you describe does not sound coronary artery spasm related to me but what do I know. I am not a doctor. I have had that sensation before though. I always attribute it...


 
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