By Diana Holdright, Hugh Montgomery
(BMJ Books) UCL Hospitals, London, united kingdom. greater than a hundred questions are replied by way of prime cardiologists. useful advisor to administration of advanced occasions. For practitioners and citizens. Softcover.
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Extra resources for 100 Questions in Cardiology
Preliminary evidence from the Post Coronary Artery Bypass Trial4 suggests that lower is better but this was an angiographic rather than an event study. Ongoing studies such as TNT and SEARCH will provide more definitive information on this question. 5mmol/l. References 1 Scandinavian Simvastatin Survival Study Group. Randomised trial of cholesterol lowering in 4444 patients with coronary heart disease. The Scandinavian simvastatin survival study. Lancet 1994; 344: 1383–9. 2 Sacks FM, Pfeffer MA, Moye LA et al.
2 Unfractionated heparin reduces ischaemic episodes but most trials have not shown greater benefit from heparin and aspirin compared with aspirin alone. g. 4 Thrombolytics are of no proven benefit and should be avoided. References 97: 1. Theroux P, Fuster V. Acute coronary syndromes. Circulation 1998;9 1195–206. 2. National Institute for Clinical Excellence. Guidance on the use of glycoprotein IIb/IIIa inhibitors in the treatment of acute coronary syndromes. Technology Appraisal Guidance-No. 12, September 2000.
Calcium antagonists are effective anti-ischaemic and vasodilator drugs. However, in the absence of beta blockade, nifedipine should be avoided due to reflex tachycardia. Verapamil and diltiazem have useful rate-lowering properties, but should be used cautiously in patients with ventricular dysfunction and patients already taking beta blockers. Beta-adrenoceptor blockers are an important treatment in unstable angina, not only relieving symptoms but also reducing the likelihood of progression to infarction and cardiac death.