Prevalence, awareness, treatment, and control of hypertension in Lebanon.

The prevalence and factors related to hypertension (HTN) treatment and control are well investigated in the Western world but remain poorly understood in the Middle East and in middle-income countries such as Lebanon. In order to measure the prevalence, awareness, treatment, and control rates of HTN in Lebanon, the authors measured blood pressure (BP) in 1697 adults. The prevalence of optimal BP (<120/80 mm Hg) was 33% and that of pre-HTN (BP ≥120/80 mm Hg but <140/90 mm Hg) was 30%.

Benefit and tolerability of the coadministration of ezetimibe and atorvastatin in acute coronary syndrome patients.

Background And Aim: The effect of ezetimibe-statin combination on inflammatory markers in acute coronary syndrome is unknown. The aim of our study is to evaluate the effect of this combination on the lipid profile, the CRP hs and the sCD40 ligand levels in acute coronary syndrome (ACS) patients.

Methods: This is a randomized, double-blind study including 93 patients admitted for ACS randomized in 2 groups, ezetimibe 10 mg + atorvastatin 10 mg vs atorvastatin 20 mg + placebo, for 12 weeks follow-up; blood samples were collected for lipid profile, ALT, AST, CRP and sCD40L at baseline, 12 hours, 4 weeks, and 12 weeks.

Effect of high bolus dose tirofiban on the inflammatory response following percutaneous coronary intervention.

Background: Tirofiban at the bolus dose of 10 microg/kg does not suppress the inflammatory response following percutaneous coronary intervention (PCI). This may be due to less than optimal inhibition of platelet aggregation. High bolus dose tirofiban (25 microg/kg) allows better inhibition of platelet aggregation but its anti-inflammatory effect remains unknown.

[Control of blood pressure morning surge in a Lebanese hypertensive population].

Objective: The primary endpoint of this prospective clinical study is to ascertain the degree of blood pressure control in the early-morning hours after 8 weeks of treatment with Telmisartan in hypertensive patients using home blood pressure measurements.

Methods: Two hundred forty Lebanese patients with uncontrolled hypertension are enrolled in the study. The blood pressure is measured at the initial visit, then at week 4 of follow-up (optional visit) and after the 8 weeks period, by the physician at his office (with pulse rate) and by the patient at home in the morning.

[Coronary angioplasty for primary cardiogenic shock following acute myocardial infarction].

Background: In the setting of acute myocardial infarction (AMI), several investigators have demonstrated that emergency coronary angioplasty (PTCA) reduces in-hospital mortality of primary cardiogenic shock (CS) from 90% to less than 50% ; however, few studies have focused on the current outcome of non selected patients in whom the onset of AMI is immediately complicated by CS.

Purpose Of The Study: To evaluate in-hospital mortality of the patients admitted to our institution for Q wave AMI presented in CS.

Material And Method: Between 05/93 and 05/03, 30 consecutive pts, 26 men and 4 women, in CS following AMI were treated with direct PTCA, 26 without thrombolysis and 4 as rescue after failed streptokinase.

Effects of clopidogrel on soluble CD40 ligand and on high-sensitivity C-reactive protein in patients with stable coronary artery disease.

Background: Antiplatelet therapy with clopidogrel decreases ischemic complication especially in patients with acute coronary syndromes or after percutaneous coronary interventions. Our study was designed to test the effects of clopidogrel on soluble CD40 ligand (sCD40l) and on high-sensitivity C-reactive protein (hs-CRP) in patients with stable coronary artery disease (CAD).

Methods: This is a randomized, double-blind, placebo-controlled study.

[Management of acute transmural myocardial infarction: a study on 200 patients admitted to a tertiary care medical center].

Objective: To verify if the management of acute transmural myocardial infarction in a university hospital, follows the international guidelines of the ACC/AHA.

Design: This is a retrospective study on 200 consecutive patients admitted with an acute transmural myocardial infarction. Data were obtained by review of medical records.

Effects of tirofiban and statins on high-sensitivity C-reactive protein, interleukin-6, and soluble CD40 ligand following percutaneous coronary interventions in patients with stable coronary artery disease.

This study assessed the effects of tirofiban and statins on high-sensitivity C-reactive protein, interleukin-6, and soluble CD40 ligand after percutaneous coronary intervention in patients who had stable coronary artery disease. Tirofiban insignificantly limited the increase of soluble CD40 ligand after revascularization, especially in patients who had high levels of this marker at baseline (p = 0.06), whereas statins significantly inhibited increases in interleukin-6 and, to a lesser extent, high-sensitivity C-reactive protein without affecting the soluble CD40 ligand.

T wave pacing inducing electrical storm and multiple shocks in an ICD-recipient: a novel complication of the automatic gain control function.

Implantable cardioverter-defibrillator (ICD) is highly effective in treating life-threatening ventricular arrhythmias, but it can also have proarrhythmic effect in some cases. We report the case of a 72 years old patient with an ischemic cardiomyopathy in whom an ICD was implanted for a poorly tolerated ventricular tachycardia (Profiles MD-Ventritex). Forty-eight hours after implantation, the patient suddenly received 15 successive shocks.