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A variant form of acute reversible cardiomyopathy: a case report
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Effect of lipid levels and lipid-lowering therapy on restenosis after coronary artery stenting.
Effect of lipid levels and lipid-lowering therapy on Restenosis after coronary artery stenting
Background. Recent experimental and clinical data suggest that lowering
serum lipid levels with statins may prevent or delay the process of
restenosis. The purpose of this trial is to determine whether lipid
levels relate to restenosis and/or whether statin therapy can prevent or
delay the process of restenosis after intracoronary stenting. Methods:
One hundred thirty-six patients who underwent single coronary artery
stenting from June 1995 to June 1997 in our institution were included in
the study. All these patients were followed for at least 9 months (mean
392 +/- 148 days) for major adverse cardiac events (MACE). We defined as
MACE the occurrence of death, myocardial infarction, or need for target
lesion revascularization. From this cohort, 103 patients had at least
one lipid parameter from the lipid profile evaluated within 2 months
from the date of the procedure. Patients who had the stent because of an
acute myocardial infarction were included in the study only if their
lipid profile was evaluated before or at least 6 weeks after the event.
Patients with triglyceride levels above 500 had both triglyceride and
low-density lipoprotein cholesterol levels excluded from the statistical
analysis. Patients were divided into two groups based on lipid levels:
normal (Group 1; n = 31) and elevated (Group II; n = 72). Patient
outcomes were also analyzed by statin therapy use. Results: There was no
significant difference in MACE rates between the two groups when
outcomes were analyzed by lipid levels (22.6% versus 20.8% P = 0.8).
Furthermore, outcomes were analyzed by use of statin therapy (Group III,
n = 53, on statin versus Group IV, n = 50, on no statin). There was also
no difference in MACE rates between the two groups (20.8% versus 22%;
P = 0.8). Conclusion: The process of restenosis has unique features that
differentiate it from atherosclerosis. Although lipid-lowering therapy
is crucial in delaying the process of atherosclerosis, its role in the
prevention of restenosis is yet to be proven
Heartscore calculated in individuals younger than 40 years is related to vascular markers of early atherosclerosis
Effect of Postablation Statin Treatment on Arrhythmia Recurrence in Patients With Paroxysmal Atrial Fibrillation
Background: Statins have been proposed as a means to prevent
postablation atrial fibrillation (AF) recurrences, mainly on the basis
of their pleiotropic effects. The objective of this subanalysis of a
prospectively randomized controlled study population of patients
undergoing radiofrequency ablation for paroxysmal AF was to test the
hypothesis that statin treatment is associated with longer time to
recurrence.
Methods and Results: This is a subanalysis over an extended follow-up
period of a prospective randomized study (ClinicalTrials.gov Identifier
NCT01791699). Among 291 patients, 2 propensity score-matched subgroups
of patients who received or did not receive statins after pulmonary vein
isolation were created. In the unmatched cohort, there was no difference
in the rate of recurrence between statin-treated and not treated
patients, with a 1-year recurrence estimate of 19% and 23%,
respectively (Gehan statistic 0.59, P = 0.443). In the
propensity-matched cohort (N = 166, 83 per group), recurrence-free
survival did not differ significantly between groups (839 days, 95%
confidence interval 755-922 days, in the no statin group vs. 904 days,
95% confidence interval 826-983 in the statin group; P = 0.301). The
1-year recurrence rate estimate was 30% in the no statin group versus
27% in the statin group (Gehan statistic 0.56, P = 0.455).
Conclusion: Statin treatment does not seem to affect AF recurrence in
following radiofrequency ablation for paroxysmal AF, over a follow-up
time of about 2.5 years