Effect of Evolocumab on Progression of Coronary Disease in Statin-Treated Patients: The GLAGOV Randomized Clinical Trial.

Importance: Reducing levels of low-density lipoprotein cholesterol (LDL-C) with intensive statin therapy reduces progression of coronary atherosclerosis in proportion to achieved LDL-C levels. Proprotein convertase subtilisin kexin type 9 (PCSK9) inhibitors produce incremental LDL-C lowering in statin-treated patients; however, the effects of these drugs on coronary atherosclerosis have not been evaluated.

Objective: To determine the effects of PCSK9 inhibition with evolocumab on progression of coronary atherosclerosis in statin-treated patients.

Vorapaxar in the secondary prevention of atherothrombotic events.

Background: Thrombin potently activates platelets through the protease-activated receptor PAR-1. Vorapaxar is a novel antiplatelet agent that selectively inhibits the cellular actions of thrombin through antagonism of PAR-1.

Methods: We randomly assigned 26,449 patients who had a history of myocardial infarction, ischemic stroke, or peripheral arterial disease to receive vorapaxar (2.

Erectile dysfunction in patients with cardiovascular disease.

Erectile dysfunction is a highly prevalent disease, especially in cardiovascular-compromised men. Many of the well-established risk factors for cardiovascular disease are also risk factors for erectile dysfunction. A correlation between erectile dysfunction and endothelial dysfunction is well established.

Be smart, don't kick the heart.

Blunt chest trauma is a rare cause of cardiac pathology. Nevertheless, a variety of life-threatening cardiac diseases can be caused by blunt chest traumas. In this case report we describe a myocardial infarction associated with kickboxing.

Ventricular fibrillation and rhabdomyolysis after administration of succinylcholine.

Succinylcholine is a depolarising muscle relaxant. Because of its quick onset of action, it is particularly used in situations which require urgent intubation. However, there have been several reports of cardiac arrest after administration of succinylcholine.

Temporal arrest.

Two patients are presented in which documented periods of asystole were caused by temporal epilepsy. Pacemaker implantation prevented total collapse but episodes of near collapse continued. After institution of anti-epileptic drug treatment both patients are free of symptoms.

Recurrent pacemaker lead induced axillary subclavian vein thrombosis.

This report describes a patient with two recurrences of axillary subclavian vein thrombosis more than 1 year after implantation of a permanent transvenous pacemaker. Both recurrences were successfully treated with local thrombolysis.

Friction and fluid: correlating pericardial effusion and pericardial friction rub.

Background: In this study the relationship between pericardial friction rub (PFR) and the degree of pericardial effusion was investigated.

Methods: A retrospective study was performed involving all patients for whom the diagnosis pericarditis was made on clinical grounds (type of chest pain, fever, laboratory findings and/or electrocardiographic signs) in the period 1990-1999. In this patient group (n=138) the presence of PFR was correlated against the amount of pericardial effusion measured echocardiographically.

Angiographic assessment of prospectively determined non-invasive reperfusion indices in acute myocardial infarction.

Objective: To investigate the value of non-invasive reperfusion indices in acute myocardial infarction, avoiding the possible need for acute coronary angiography and subsequent angioplasty.

Design: In a prospective angiographic study, seven potential ECG or clinical markers of reperfusion were analysed in 230 patients with acute myocardial infarction. In all patients two 12 lead ECGs were used: the ECG on admission and the ECG immediately before coronary angiography.

Value of the electrocardiogram in localizing the occlusion site in the left anterior descending coronary artery in acute anterior myocardial infarction.

Objectives: The study assessed the value of the electrocardiogram (ECG) as predictor of the left anterior descending coronary artery (LAD) occlusion site in relation to the first septal perforator (S1) and/or the first diagonal branch (D1) in patients with acute anterior myocardial infarction (AMI).

Background: In anterior AMI, determination of the exact site of LAD occlusion is important because the more proximal the occlusion the less favorable the prognosis.

Methods: One hundred patients with a first anterior AMI were included.