Current vascular pharmacology
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Curr Vasc Pharmacol · Jan 2013
ReviewPerioperative/periprocedural effects of statin treatment for patients undergoing vascular surgery or endovascular procedures: an update.
We reviewed the literature for studies evaluating the effects of statins on vascular patients undergoing open surgical or endovascular procedures. ⋯ Statins are associated with several beneficial actions in patients undergoing open surgical or endovascular procedures. Nevertheless, statin use in vascular patients still remains underutilized and suboptimal. Ideally, statins should be initiated a minimum of 2 weeks before the procedure. Extended-release formulas may be preferable perioperatively to cover the first 1-2 days after the procedure when oral intake may not be feasible. Statins should be administered to all vascular disease patients, whether they are managed conservatively or are undergoing open surgical or endovascular procedures.
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Curr Vasc Pharmacol · Jan 2013
Randomized Controlled Trial Meta AnalysisIntensive glucose control in diabetics with an acute myocardial infarction does not improve mortality and increases risk of hypoglycemia-a meta-regression analysis.
Some early trials comparing intensive glucose control in type 2 diabetics with an acute myocardial infarction (MI) reported a decrease in mortality over a short period of follow up leading to a presumption of improved survival with intensive glucose control. Later data refuted this hypothesis. The 2009 ACC/AHA focused update on ST elevation MI gave a weak recommendation for the use of an insulin based regimen to achieve and maintain blood glucose less than 180 mg/dL. We decided to assess the validity of this recommendation. ⋯ This systematic review suggests limited benefit of intensive glycemic control in type 2 diabetics with an MI, with a significant risk of serious hypoglycemia.