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NEJM - Colección Enfermedad Coronaria

Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease
21/9/2017
ver resumen
Current pharmaceutical interventions that are designed to slow the progression of atherosclerosis focus almost exclusively on reducing plasma levels of cholesterol. However, clinical and experimental data support an additional critical role for inflammation in atherothrombosis. We previously found…

Bivalirudin versus Heparin Monotherapy in Myocardial Infarction
21/9/2017
ver resumen
Anticoagulation with heparin or bivalirudin, in combination with antiplatelet agents such as aspirin, P2Y12 inhibitors, and glycoprotein IIb/IIIa inhibitors, is routinely used to improve angiographic and clinical outcomes in patients undergoing percutaneous coronary intervention (PCI) for acute…

Targeting Inflammation in Coronary Artery Disease
21/9/2017
ver resumen
For more than 20 years, our understanding of the biology of atherosclerosis has incorporated the so-called inflammatory hypothesis. Inflammatory cells and signals drive the healing response to vascular injury, allowing the initiation and growth of atherosclerotic plaque. Inflammatory reactions…

Procedural Anticoagulation in Myocardial Infarction
21/9/2017
ver resumen
The prognosis for patients with ST-segment elevation myocardial infarction (STEMI) and non-STEMI (NSTEMI) is improved with the use of percutaneous coronary intervention (PCI). Choosing the best procedural anticoagulation regimen to balance the risks of ischemia and bleeding during PCI is essential…

Left Ventricular Free-Wall Rupture
7/9/2017
ver resumen
Figure 1.

Liraglutide and Renal Outcomes in Type 2 Diabetes
31/8/2017
ver resumen
Persons with type 2 diabetes mellitus, particularly those with evidence of cardiovascular disease, are at high risk for chronic kidney disease. In most countries, diabetic kidney disease is reported to be the leading cause of dialysis-dependent chronic kidney disease. Efforts to blunt the global…

A New Chapter for Diabetic Kidney Disease
31/8/2017
ver resumen
Many clinical outcomes have improved over the past two decades for people living with diabetes. However, relatively little progress has been made in the treatment of diabetic kidney disease. Among adults with diabetes in the United States, the prevalence of diabetic kidney disease has remained…

Effects of Anacetrapib in Patients with Atherosclerotic Vascular Disease
29/8/2017
ver resumen
Evidence from large-scale, randomized trials has shown that each reduction of 40 mg per deciliter (1 mmol per liter) in the level of low-density lipoprotein (LDL) cholesterol reduces the risk of coronary events (including coronary death, myocardial infarction, and revascularization procedures) and…

Oxygen Therapy in Suspected Acute Myocardial Infarction
28/8/2017
ver resumen
Myocardial infarction is caused by a mismatch of oxygen and substrate supply and demand in the myocardium that leads to ischemia and ultimately to cell death. Therefore, for more than a century, supplemental oxygen has been used routinely in the treatment of patients with suspected acute myocardial…

Is Oxygen Therapy Beneficial in Acute Myocardial Infarction? Simple Question, Complicated Mechanism, Simple Answer
28/8/2017
ver resumen
Joseph Priestley first reported his discovery of oxygen in 1775 through observations of a candle burning in "dephlogisticated air." He remarked that the candle burned with great "strength and vivacity" and speculated that this oxygen-enriched air could be used as a medicine; he also expressed…

Rivaroxaban with or without Aspirin in Stable Cardiovascular Disease
27/8/2017
ver resumen
Despite the use of effective secondary prevention strategies, 5 to 10% of patients with cardiovascular disease have recurrent events each year. When used for secondary prevention, aspirin results in a 19% lower risk of major adverse cardiovascular events and a 9% lower risk of cardiovascular death…

An Important Step for Thrombocardiology
27/8/2017
ver resumen
It has been known for more than a century that coronary-artery thrombosis is the most common precipitant of acute myocardial infarction and that atherosclerotic plaques in the coronary arteries are often responsible for angina pectoris. When anticoagulants and antiplatelet agents became available,…

Effect of Intensive Blood-Pressure Treatment on Patient-Reported Outcomes
24/8/2017
ver resumen
The Systolic Blood Pressure Intervention Trial (SPRINT) showed that among older adults with hypertension and a high risk of cardiovascular disease, but without prevalent diabetes or a history of stroke, blood-pressure treatment that targeted a systolic blood pressure of less than 120 mm Hg…

Cost-Effectiveness of Intensive versus Standard Blood-Pressure Control
24/8/2017
ver resumen
The most effective blood-pressure goals for treatment with antihypertensive medications are uncertain. Treating hypertension to standard systolic blood-pressure goals is cost-saving or cost-effective among patients at high risk for cardiovascular disease in the United States. However, until…

Venous Congestion in Ischemic Bowel
24/8/2017
ver resumen
Figure 1.

Five-Year Outcomes after On-Pump and Off-Pump Coronary-Artery Bypass
17/8/2017
ver resumen
In the 1990s, enthusiasm reemerged for performing coronary-artery bypass grafting (CABG) surgery on a beating heart without the use of cardiopulmonary bypass (off pump). Patients with poor cardiac function or complex coexisting conditions (e.g. lung disease or stroke) initially appeared to have…

Cognitive Function in a Randomized Trial of Evolocumab
17/8/2017
ver resumen
Statin therapy, ezetimibe, and the proprotein convertase subtilisin–kexin type 9 (PCSK9) inhibitor evolocumab have been shown to reduce the rate of cardiovascular events among patients with established cardiovascular disease. These therapies may result in very low levels of low-density lipoprotein…

Changing the Discussion about On-Pump versus Off-Pump CABG
17/8/2017
ver resumen
The performance of coronary-artery bypass grafting (CABG) without the use of the heart–lung machine (pump) was introduced to avoid the damaging effects of cardiopulmonary bypass. On-pump CABG with cardiopulmonary bypass is generally performed on an arrested heart, and off-pump CABG on a beating…

Genetic and Pharmacologic Inactivation of ANGPTL3 and Cardiovascular Disease
20/7/2017
ver resumen
Angiopoietin-like proteins (ANGPTLs) have been established as important regulators of lipoprotein metabolism and have thus emerged as attractive targets for modulation of lipid levels and cardiovascular disease risk. Loss-of-function variants in ANGPTL4, a negative regulator of lipoprotein lipase…

Cardiovascular and Metabolic Effects of ANGPTL3 Antisense Oligonucleotides
20/7/2017
ver resumen
Despite advances in the development of lipid-lowering therapies, clinical trials have shown that a substantial risk of cardiovascular disease persists after currently recommended medical therapy. For example, in one trial involving patients who had had an acute coronary syndrome, the lowering of…






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