Archives of cardiovascular diseases
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Arch Cardiovasc Dis · Jan 2009
Efficacy over time of a short overall atherosclerosis management programme on the reduction of cardiovascular risk in patients after an acute coronary syndrome.
The prognostic significance of monitoring risk factors and adjusting treatments in patients after an acute coronary syndrome (ACS) is well documented. However, studies over the last few years show that secondary prevention objectives are rarely met. Prevention programmes are effective but their benefit is only partially maintained in long-term follow-up. ⋯ Six hundred and sixty consecutive patients were hospitalised three months after the occurrence of an ACS to evaluate residual risk factors, the atherosclerosis burden, and to undergo a treatment adjustment and a therapeutic and dietary education programme. We evaluated the impact of this long-term programme on the balance of risk factors, treatment maintenance and clinical events. At the end of an average follow-up of 20 months, 96.3% of patients were on antiaggregates, 86.0% were on beta-blockers or Verapamil, 62.4% were on angiotensin-converting enzyme inhibitors or angiotensin to receptor antagonists, 88.4% were on cholesterol-lowering medication and 75.5% were receiving a combination of beta-blocker antiaggregates and cholesterol-lowering drugs. Monitoring of LDL cholesterol and blood pressure was done in over 81 and 71% of patients, respectively. At 20 months of follow-up, total mortality was 3.6% and one cardiovascular event occurred in 12% of patients. In conclusion, this short programme following ACS is beneficial for the long-term management of cardiovascular risk factors and the sustainability of drug treatments.
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Arch Cardiovasc Dis · Jan 2009
Prevention of venous thromboembolism among inpatients at Cotonou teaching hospital, Benin.
The aim of this retrospective study was to evaluate the use and appropriateness of preventive measures for venous thrombosis among adult inpatients in a Benin teaching hospital. ⋯ The risk of venous thromboembolic is recognized but poorly managed in this Bénin teaching hospital.
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Arch Cardiovasc Dis · Oct 2008
ReviewSurgical or medical treatment for thrombus straddling the patent foramen ovale: impending paradoxical embolism? Report of four clinical cases and literature review.
Thrombus straddling the patent foramen ovale (TSFO) is a rare event. It occurs in the presence of pulmonary embolism and can be responsible for paradoxical embolism. The aim of this report is to guide the optimal choice of treatment for TSFO in different clinical contexts. ⋯ Medical treatment with heparin tends to be used as a second option in patients with more frequent comorbidities and strokes but the mortality rate is similar to that in the surgical group. Surgery seems to be justified in the prevention of paradoxical embolism. Thrombolysis is more frequently chosen in the higher risk group and is associated with the greatest mortality.
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Arch Cardiovasc Dis · Oct 2008
Editorial CommentThe straddling atrial thrombus: from image to treatment.