[Which information should be given to the patient concerning the cardiovascular and renal risk of the NSAIDs?].

Objective: Patient information is a topical subject. The aim of this review is to present the rare studies concerning the degree of patient information on the cardiovascular and renal risks of the non-steroidal anti-inflammatory drugs and to suggest some recommendations on this subject.

Methodology: After analysis of the literature (Medline search - January 2006), a series of recommendations has been drawn up following discussion among experts from different specialties (clinical epidemiology, rheumatology, cardiology, nephrology, gastroenterology).

[How to watch over a patient treated with a NSAID in relation to the cardiovascular and renal risk?].

Despite the cardiovascular risk attributable to the NSAIDs, these drugs are among the most prescribed treatments in the world. Recently to manage this risk during chronic inflammatory rheumatisms a surveillance plan has been developed based on a decision algorithm. Given that the arterial thrombotic risks (myocardial or cerebral) are observed essentially during long-term treatments, two types of situation have been envisaged, short-term treatments and long-term treatments.

[Are there any differences in the cardiovascular tolerance between classical NSAIDs and coxibs?].

Three placebo-controlled studies have demonstrated deleterious cardiovascular (CV) effects of rofecoxib, celecoxib, and pare/valdecoxib. It remains to be determined whether this CV toxicity is specific to coxibs, or shared with all non-steroidal anti-inflammatory drugs (NSAID). Seven meta-analyses show that, in comparison with non-specific NSAIDs, the risk of thrombotic CV accident is increased with rofecoxib and celecoxib, but not with valdecoxib or lumiracoxib.

[Which information should be given to the patient concerning the cardiovascular and renal risk of the NSAIDs?].

Objective: Patient information is a topical subject. The aim of this review is to present the rare studies concerning the degree of patient information on the cardiovascular and renal risks of the non-steroidal anti-inflammatory drugs and to suggest some recommendations on this subject.

Methodology: After analysis of the literature (Medline search - January 2006), a series of recommendations has been drown up following discussion among experts from different specialties (clinical epidemiology rheumatology cardiology nephrology gastroenterology).

[How to watch over a patient treated with a NSAID in relation to the cardiovascular and renal risk?].

Despite the cardiovascular risk attributable to the NSAIDs, these drugs are among the most prescribed treatments in the world. Recently to manage this risk during chronic inflammatory rheumatisms a surveillance plan has been developed based on a decision algorithm. Given that the arterial thrombotic risks (myocardial or cerebral) are observed essentially during long-term treatments, two types of situation have been envisaged, short-term treatments and long-term treatments.

[Are there any differences in the cardiovascular tolerance between classical NSAIDs and coxibs?].

Three placebo-controlled studies have demonstrated deleterious cardiovascular (CV) effects of rofecoxib, celecoxib, and pare/valdecoxib. It remains to be determined whether this CV toxicity is specific to coxibs, or shared with all non-steroidal anti-inflammatory drugs (NSAIDs). Seven meta-analyses show that, in comparison with non-specific NSAIDs, the risk of thrombotic CV accident is increased with rofecoxib and celecoxib, but not with valdecoxib or lumiracoxib.

Aggregates of endothelial microparticles and platelets circulate in peripheral blood. Variations during stable coronary disease and acute myocardial infarction.

Introduction: Activated endothelial cells on the surface of atherosclerotic plaques can shed membrane microparticles (MPs) with procoagulant potential. We have investigated whether circulating endothelial MPs could bind platelets, form aggregates, and be involved in thrombus formation during acute myocardial infarction (AMI).

Patients/methods And Results: We first assessed the in vitro formation of aggregates comprising endothelial MPs and platelets by incubating supernatants of activated endothelial cells in culture with freshly isolated platelets.

Different effects of mibefradil and amlodipine on coronary vessels and during beta-adrenergic stimulation in conscious dogs.

Coronary effects of Ca -channel blockers mibefradil and amlodipine were compared in conscious dogs. Ten dogs were instrumented for measurement of aortic and left ventricular pressures, circumflex coronary blood flow velocity (CBFv), and coronary diameter (CD). A permanent catheter was implanted in the circumflex coronary artery.

Successful bridge to transplantation in a patient with Becker muscular dystrophy-associated cardiomyopathy.

A 28-year-old male patient diagnosed with Becker muscular dystrophy (BMD)-associated cardiomyopathy was successfully bridged to transplantation with the Cardiowest total artificial heart. Dramatic improvement of muscular functional status occurred following transplantation.

Reduced coronary vasodilator responses to amlodipine in pacing-induced heart failure in conscious dogs: role of nitric oxide.

1. This study examined whether NO is involved in the in-vivo coronary vasodilator effects of amlodipine (a calcium channel blocker) and whether heart failure (HF) alters the coronary responses to amlodipine. 2.

[Acute coronary syndromes in patients treated with HIV protease inhibitors].

Introduction: Cardiovascular complications occurring in patients infected by the human immunodeficient virus (HIV) have considerably changed since the appearance, in April 1996, of highly active antiretroviral tri-therapy (HAART), associating reverse transcriptase and protease HIV-1 inhibitors. The spectacular efficacy of anti-proteases has led to the almost complete disappearance of these opportunistic complications. However, in May 1998, acute coronary accidents were reported in the literature, thus questioning the possible responsibility of antiprotease treatment in the occurrence of accelerated atheroma.

Brain natriuretic peptide blood levels in the differential diagnosis of dyspnea.

Study Objectives: In dyspneic patients without left ventricular enlargement, it may be difficult to differentiate between obstructive lung disease and diastolic heart failure. Determination of plasma brain natriuretic peptide (BNP) levels, known to increase with ventricular stretch, may be of clinical relevance in this situation. We compared the discriminant power of BNP blood levels and of echocardiography in patients with either chronic obstructive lung disease or diastolic heart failure.

[Anomalous origin of coronary arteries from three separate ostia in the right sinus of valsalva. A case port and review of the literature].

The authors report the case of a patient undergoing coronary angiography for a lateral myocardial infarction related with atherosclerosic lesions but associated with a rare anomalous origin of all three coronary arteries from separate ostia in the right sinus of Valsalva. Anomalous origin of coronary arteries from the opposite sinus are potentially serious especially among young subjects and when a vessel runs between the aorta and pulmonary artery. Clinical presentation, angiographic diagnostic and treatment strategies are discussed.

Stimulation of bradykinin B(1) receptors induces vasodilation in conductance and resistance coronary vessels in conscious dogs: comparison with B(2) receptor stimulation.

Background: Constitutive bradykinin B(1) receptors have been identified in dogs; however, their physiological implications involving the coronary circulation remain to be determined. This study examined, in conscious dogs, the coronary response to des-Arg(9)-bradykinin (a B(1) receptor agonist) and the mechanisms involved.

Methods And Results: Eleven dogs were instrumented with a left ventricular micromanometer, a circumflex coronary catheter, a cuff occluder, a Doppler flow probe, and ultrasonic crystals to measure coronary blood flow velocity (CBFv) and coronary diameter (CD).

[Angioplasty with stent of the common trunk of the left coronary artery with abnormal origin at the level of the right anterior sinus and with a retro-aortic trajectory].

The authors report a case of angioplasty with implantation of a stent in an anomalous left main coronary artery arising from the right anterior sinus of Valsalva with a retro-aortic trajectory. The introduction of stenting has made angioplasty of anomalous coronary arteries a possible alternative to surgery with the reserve of a high risk of restenosis when the lesion is distal and situated at a bifurcation.

[Effects of high sodium intake on ventricular remodeling in mice].

Background: Despite extensive research, controversy still exists regarding the role of dietary sodium intake on hypertension and left ventricular (LV) hypertrophy. Echocardiography is a powerful tool to assess LV hypertrophy and recent technical developments allow now its use in small animals.

Methods: We examined the effect of high sodium intake on LV geometry using echocardiography in mice.

[Are beta-blockers really depressogenic?].

More than 25 years of the use of systemic beta-blockers in cardiovascular pathologies, but also in various other indications, have yielded a number of reports suggesting that these drugs was linked with the development of clinical depression. Some retrospective studies have been carried out with positive results, but the rare longitudinal prospective studies have failed to confirm the association between beta-blockers use and depression. Clinical, methodological and pharmacological problems may explain these discrepancies and are of great interest.