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All Medical Information provided in this website are only informative. Ask your Physician for any personal application.

 

 

 

Aspirin associated to NSAID,  more cardiac protection

Nonsteroidal anti-inflammatory drugs =( NSAID = diclofenac, naproxen and ibuprofen ) associated to low dose Aspirin =(80 to 325 mg per day) reduce cardiac risk in patients who suffered from myocardial infarction more than aspirin alone.

Source = 66th Annual Scientific Meeting of the American College of Rheumatology

 

 

Zetia for treating cholesterol

A new drug approved recently by FDA to lower LDL cholesterol, Zetia, works by preventing the intestines from absorbing cholesterol. Associating Statins with this new drug possibly increases its efficacy by 25%.

Source = Schering-Plough Corp. and Merck and Co. Inc.

 

 

Citicoline After Stroke 

With Citicoline 2000 mg given orally during the 24 hours following a moderate to severe stroke, a complete resolution can be obtained.

Source = Stroke 2002;33:

 

 

Hypertension in Women and Paracetamol (Acetaminophen)

Women taking Paracetamol (Acetaminophen) or Nonsteroidal anti-inflammatory drugs =( NSAID = diclofenac, naproxen and ibuprofen etc... ) may see high blood pressure even after infrequent use! The risk may be up to 200% after 22 days/month of paracetamol.

Source = Arch Internal Med 2002;162:2204-2208

 

 

Taking double dose of Atorvastatin every other day reduces more your LDL cholesterol than taking one dose daily, thus reducing cost and increasing efficacy.

Source = Am Heart J. 2002;144:674-677

 

 

By treating your hypertension, you reduce your risk of developing cognitive impairment.

Significantly less dementia by 55% can be obtained by any antihypertensive drug.

But using calcium channel blockers could be more effective in preventing dementia.

Source = Arch Intern Med 2002;162:2046-2052,2090-2096

 

 

More Antibiotics, Less Stroke.

Patients previously infected with Chlamydia pneumoniae may reduce their CRP and their carotid thickness if treated by roxithromycin 150 mg twice-daily for 30 days. Stroke (and cardiac events) are thus significantly prevented.

Source = Circulation. 2002;106

 

 

Inflammatory markers (C-reactive protein & TNF-alpha) have important adverse properties in promoting acute coronary events.  They are significantly reduced by statins but not by diet.

People under statins & diet can be satisfied even if their lipid levels are not normalized since statins lower cardiovascular risk by through independant ways.

Source = Arterioscler Thromb Vasc Biol 2002;22:e19-e23

 

 

Beta blocker has little erectile dysfunction when ignoring it. Psycholgy plays a very important role in beta blockers erectile dysfunction.

 

 

Magnesium is abdolutely not benefitial after myocardial infarction.

 

 

Drugs gaining importance : Carvedilol, Perindopril, Aldosterone blocker, Captopril.

 

 

Losartan not better than Captopril after severe myocardial infarction.

 

 

Treatment with Roxithromycin in acute Myocardian Infarction is not useful.

 

 

Simvastatin, a lipid lowering agent, may decrease hypertension in some rats.

Source = Hypertension 2002;40:142-147

 

 

A new study published this week shows again that antibiotics given at moderate dose for one week during a heart attack can decrease by 40 % heart events for one year at least. This benefit is not linked to present infection or not but seems to act through decrease of CRP and Fibrinogen.

Source = Circulation. 2002;106 (August issue)

 

 

Depression in patients with heart disease can be treated with Sertraline with no significant harm.

Source = JAMA. 2002;288(6):701-709, 750-751

 

 

Death of cardiac people can be reduced by 75% by a simple shot of the Flu vaccine plus a reduction in infarction and angina.

Source = Circulation 2002;105:r82-r86

 

 

The World Health Organization recommend the vaccine for cardiac people for a long time ago, but these results are more inportant than expected. Previous studies showed also a reduction in stroke after a shot of flu vaccine. The mechanism of action of the flu vaccine is still not specified but it concerns the inflammatory process.

Take care when you are taking Aspirin and switch to COX-2 inhibitor (an anti-inflammatory agent) : Platelets can be activated which leads to thrombosis and cardiovascular events (infarction, stroke, pulmonary embolism etc...)

Source = Science 2002;296:539-541

 

 

rtPA treatment is beneficial for all types of stroke. No need to wait to diagnose the type of stroke.

Source = American Academy of Neurology (AAN) 54th annual meeting

 

 

A new cholesterol treating agent which increases good cholesterol (HDL) : the cholesteryl ester transfer protein inhibitor (CETP) .The results begin to appear the first week of treatment. No action on Triglycerides. No significant side-effects.

Source = Circulation 2002;105  

 

 

Treprostinil  given subcutaneously can safely treat pulmonay hypertension.

Source = Am J Respir Crit Care Med 2002;165:800-804

 

 

Again and again,Statins seem good for Alzheimer's disease. Other anticholesterol agents have no effect on Alzheimer's disease.

Souce = American Academy of Neurology (AAN) 54th annual meeting

 

 

Low dose Niacin (50 mg /12h) for patients receiving statin (anticholesterol) therapy: More benefit by still HDL increase.

Source = Am Heart J 2002;143:514-518

 

 

Vasospasm of cerebral arteries after ruptured aneurysms repair may be preventing by implanting small pellets of long acting Nicardipine ( a dihydropyridine calcium channel blocker used to treat hypertension ).

Source = Stroke 2002;33:1011-1015

 

 

Nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) or Aspirin ? Same benefit after myocardial infarction.Patients receiving chronic NSAID treatment should not receive aspirin post MI.Those allergic to Aspirin may replace it by Nsaid.

Source = Am Heart J 2002;143:381-382,475-481

 

 

Atorvastatin 80 mg per day (an intensive cholesterol-lowering therapy) lowers blood pressure and large arterry stiffness.

Source = J Am Coll Cardiol 2002;39:1020-1025

 

 

Vitamins C and E slow the progression of arteriosclerosis  in heart transplant patients.Animal Studies : Vitamins C and E, can improve survival.

Source = Lancet 2002;359:1108-1113

 

 

Stroke Risk After Carotid Angioplasty:Equal benefit from Heparin and Abciximab

Source = Neurosurgery 2002;50:466-475.

 

 

Again, many differences between Statins properties and benefits:ATORVASTATIN v/s SIMVASTATINAtorvastatin better for treating  LDL, Triglycerides.Simvastatin for HDL

Source = Am J Cardiol 2002;89:667-671.

 

 

After surgery for abdominal or pelvic cancer,  Enoxaparin, for the prevention of venous thromboembolism, for four weeks, is safe and significantly reduces the incidence of thrombosis, more than enoxaparin prophylaxis for one week.

Source = N Engl J Med. 2002;346(13):975-980

 

 

Significant drug-drug interactions : Avoid Simvastatin, use Pravastatin  with AIDS drugs : concentration values for simvastatin increased by 3,000%, atorvastatin by 79%, while pravastatin declined by 50%.

Source = AIDS 2002;16:569-577.

 

 

The famous "anticholesterol" drug Pravastatin lowers Mortality in Patients With and Without cardiac disease !  collected data on 20,000 persons 5 years long : good evidence of benefit and safety .

Source = Eur Heart J 2002;23:183-184,207-215              

 

 

Insulin has anti-inflammatory properties that may reduce thrombosis, that leads to heart attack and stroke, and enhance fibrinolysis.

Source = J Clin Endocrinol Metab 2002;87:1419-1422

 

 

The calcium channel blocker amlodipine : better small artery structure and endothelial function. Atenolol, a betablocker, no effect.

Source = Am J Hypertens 2002;15:105-110.       

 

 

Amiodarone-Induced Thyrotoxicosis : easy to manage and no need to discontinue amiodarone.

Source = Circulation 2002;105:1275-1277.          Thyroid Side Effects of Amiodarone : mild or transient .

Source = American Society of Clinical Pharmacology and Therapeutics Annual Meeting.

 

 

Aspirin Resistance. Some patients may be redistant to aspirin and thus more exposed to cardiac events such as Myocardial Infarction, Stroke and may benefit from additional antiplatelet treatments or other antithrombotic therapies. High urinary levels of 11-dehydro thromboxane B2 may reveal those patients.

Source = Circulation. April 9th issue, published online March 26th.          

 

 

Genetics: Half patients resistant to Betablockers! (Arg389 genotype respond to betablockers Gly389 genotype do not)

Source = American Society for Clinical Pharmacology and Therapeutics, annual meeting.

 

 

Sudden Death : Amiodarone better than Lidocaine for patients with shock-resistant out-of-hospital ventricular fibrillation (VF).

Source = N Engl J Med 2002;346:884-890.

 

 

High risk for stroke : 32 % reduced by ACE inhibitor Ramipril. Fatal stroke : 61%. This reduction is not explained by lower blood pressure which is mild.

Source = BMJ 2002;324:699-702.          

 

 

In hypertensive patients with left ventricular hypertrophy, less mortality and morbidity if treated by Losartan than Atenolol even when they both lower hypertension equally. 25% reduction in stroke, type II diabetes  39% in mortality.

 Source = Lancet 2002;359:995-1010