[The best of coronary artery disease in 1999].
Despite the (modest) regression observed in the MONICA study, coronary artery disease remains the leading cause of mortality in industrialised countries and it is worryingly progressive in emerging countries. Therapeutic progress has been considerable but only a small number of coronary patients benefit from it. The techniques are costly and justify efforts to improve selection of high risk patients. The results of the VA-HIT study, which demonstrated the importance of HDL cholesterol level in prevention, now raise the question of the optimal treatment of these patients and that of the association of fibrates and statins. The value of ACE inhibitors in the HOPE study in coronary artery disease was outstanding. In parallel, the efficacy of Mediterranean diet has been confirmed in secondary prevention as that of supplements of omega-3 fatty acids in the GISSI-Prevenzione study. When reference anti-anginal agents are ineffective in the most resistant forms of coronary artery disease, other classes of drugs have been shown to be effective in association. Finally, the theory of inflammation and infection of atherosclerosis has found new indirect arguments, whereas angiogenesis and vasculogenesis have been confirmed as the main leaders in the future treatment of coronary artery disease.
Gayet
J L
JL
D000806:Angiotensin-Converting Enzyme Inhibitors / Q000627:therapeutic use*; D001161:Arteriosclerosis / Q000150:complications; D002986:Clinical Trials as Topic; D003327:Coronary Disease / Q000188:drug therapy / Q000209:etiology / Q000503:physiopathology; D006801:Humans; D007249:Inflammation; D011634:Public Health; D018570:Risk Assessment
D000806:Angiotensin-Converting Enzyme Inhibitors