Seminal changes in the management of the acute coronary event: current concepts.
In the past era, we held high-grade arterial stenosis responsible for the acute complications of atherosclerosis. These concepts are being reassessed. Qualitative rather than quantitative aspects of plaques (e.g., inflammation rather than plaque size) have been established as decisive determinants of their probabilities to cause acute complications. Numerous beneficial effects of statins have been demonstrated. These include lipid lowering, plaque stability, enhanced endothelial function, and antiplatelet, antiatherothrombotic, and antimacrophage activities. However, the successful medical management of CAD is also multifactorial and in addition to use of statins include beta-blockers, ACE inhibitors, and aspirin, as well as blood pressure control, diet, and exercise (see [figure: see text] Figure). The results have been not only the preventions of acute complications of atherosclerosis, but also the successes in stabilizing acute coronary events and preventing infarctions.
Futterman
Laurie G
LG
Division of Cardiology, Department of Medicine, University of Miami School of Medicine, Miami, Fla., USA.
Lemberg
Louis
L
D017023:Coronary Angiography; D003324:Coronary Artery Disease / Q000175:diagnosis / Q000178:diet therapy* / Q000188:drug therapy*; D005081:Exercise Therapy; D005260:Female; D006801:Humans; D008875:Middle Aged; D009203:Myocardial Infarction / Q000517:prevention & control*