The Canadian journal of cardiology
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Historically, management of chronic diseases such as hypertension has tended to be reactive, with patients being passive recipients of care. In recent years, the chronic care model has been developed and implemented in many jurisdictions to ensure optimal, proactive care of people with chronic conditions. ⋯ The role of the patient, primary care team, system and community are all addressed in this model. Experience suggests that application of chronic disease management principles to hypertension can result in significant benefits to all concerned.
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Adiponectin, an adipocyte-specific protein, matrix metalloproteinases (MMPs) and tissue inhibitors of metalloproteinases (TIMPs) play a crucial role in arteriosclerosis and plaque disruption. The present study was designed to elucidate the relationship of adiponectin and the ratio of MMP-9/TIMP-1 and their effects on the stability of plaque in acute coronary syndrome (ACS). ⋯ In the present study, it was found that adiponectin has a negative relationship with the ratio of MMP-9/TIMP-1 in patients with ACS, and that the ratio of MMP-9/TIMP-1 is an independent predictor of the stability of atherosclerotic plaque and the severity of coronary atherosclerosis.
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Comparative Study
Mid-term outcomes of off-pump versus on-pump coronary artery bypass graft surgery.
To evaluate survival and readmissions to hospital for cardiac events or coronary revascularization (REVASC) in patients having off-pump (OPCAB) versus conventional on-pump (CCAB) coronary artery bypass graft surgery (CABG). ⋯ The use of OPCAB remains controversial. These results, from this early experience, suggest that despite improved hospital outcomes, the lesser degree of REVASC raises concerns about the need for repeat revascularization in the OPCAB group.