Reduced Variability to Aspirin Antiplatelet Effect by the Coadministration of Statins in High-Risk Patients for Cardiovascular Disease.

We studied the influence of cardiovascular (CV) risk factors, previous CV events, and cotreatments with preventive medicines, on residual platelet thromboxane (TX)B production in 182 patients chronically treated with enteric coated (EC)-aspirin (100 mg/day). The response to aspirin was also verified by assessing arachidonic acid-induced platelet aggregation and urinary 11-dehydro-TXB levels. Residual serum TXB levels exceeded the upper limit value for an adequate aspirin response in 14% of individuals.

n-3 PUFAs and heart failure.

The risk of death of patients with heart failure (HF) is still too high in daily clinical practice despite the many progress that have occurred in the diagnosis and treatment of this syndrome that significantly reduce the mortality of these patients. Results of the GISSI-HF trial, the first and only large-scale clinical trial to date assessing the effects of n-3 polyunsaturated fatty acids (n-3 PUFAs) in HF patients, showed that treatment of 100 patients saved almost 2 lives and prevented almost 2 cardiovascular hospitalisations, indicating that beneficial cardiovascular effects of n-3 PUFAs observed in other populations might also apply to patients with HF. Treatment with n-3 PUFAs may be considered as a new option to add to the shortlist of evidence-based life-prolonging therapies for HF, as suggested by the recent guidelines of the European Society of Cardiology.

n-3 PUFAs in cardiovascular disease.

Many large, randomised clinical trials and some meta-analyses have shown that treatment with n-3 polyunsaturated fatty acids (n-3 PUFAs) is associated with consistent benefits on cardiovascular (CV) events, primarily due to a reduction of coronary and CV deaths in patients with coronary heart disease. At variance with such evidence, some clinical trials and meta-analyses showing a neutral effect of n-3 PUFAs have been recently published, raising concern about the consistency of the evidence on the CV benefits of n-3 PUFAs. Several methodological and clinical aspects of these recent trials deserve to be considered.

Why Do We Still Need Large Scale Clinical Trial: The Case of n-3 PUFA.

After the first reports about a protective effect on coronary heart disease (CHD) published more than 40 years ago, wide interest in the therapeutic use of n-3 polyunsaturated fatty acids (n-3 PUFA) aroused. Since then, many studies and meta-analyses have reported a significantly reduced risk of CHD and CV death due to fish and n-3 PUFA intake. Some of the overviews reported a significant reduction of risk of sudden cardiac death, all-cause death, and nonfatal CV events.

Uric acid: a cardiovascular risk factor in patients with recent myocardial infarction.

Background: To date uric acid (UA) is not considered a cardiovascular risk factor, although evidence about a relationship between UA and cardiovascular diseases has been reported.

Methods: Information from 10,840 patients enrolled in the GISSI-Prevenzione trial was used to evaluate the relationship between UA and risk for total mortality and cardiovascular events (CVE). UA levels were categorized in quintiles, as ≤ 4.