Death rates from coronary disease - progress and a puzzling paradox

Article Abstract:

Death rates from coronary heart disease have dropped since 1987 but the incidence of heart attack has not. A 1998 study of mortality rates from CHD in four US communities between 1987 and 1994 found a 28% reduction in men and a 31% reduction in women. During the same time period, the Third National Health and Nutrition Examination found a 40% decline in the number of people with hypertension, a 28% decline in the number with high blood cholesterol and a 25% reduction in the number of smokers. The use of thrombolytic drugs, angioplasty, beta blockers and ACE inhibitors in heart attack patients also has contributed to the drop in mortality rates.

Editorial, Statistics

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Cardiac troponins in acute coronary syndromes

Article Abstract:

Measuring troponin levels in patients with acute coronary symptoms may identify those at high risk. Three 1996 studies confirmed the role of high troponin concentrations as predictive of further complications or death in hospitalized cardiac patients. Subsequent care changes need to be evaluated in terms of overall cost-effectiveness and long-term improvement. Additional concerns include the reliability of measuring troponin at bedside and in patients with various other disorders. The use of vessel angiography or intracoronary ultrasonography may further determine appropriate treatment in patients at risk.

Health aspects, Measurement, Physiological aspects, Proteins, Diagnostic imaging, Heart cells

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Inhibition of platelet glycoprotein IIb/IIIa with eptifibatide in patients with acute coronary syndromes

Article Abstract:

The drug eptifibatide may lower the risk of non-fatal heart attack in patients with angina. This drug inhibits the aggregation of blood platelets, which are a component of blood clots. Most heart attacks are caused by blood clots in the coronary arteries. Researchers randomly assigned 10,948 patients with chest pain and evidence of reduced blood flow to the heart to receive an infusion of eptifibatide or placebo in addition to the usual care that these patients receive. Fourteen percent of those receiving eptifibatide had a heart attack compared to 15.7% of those receiving a placebo.

Evaluation, Prevention, Drug therapy, Heart attack, Ischemia, Chemical inhibitors

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