Coronary artery disease
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Coronary artery disease · Feb 2002
Characteristics and long-term outcome of patients with acute chest pain or other symptoms raising suspicion of acute myocardial infarction in relation to whether they were hospitalized or directly discharged from the emergency department.
To describe the characteristics and outcome of patients who came to the emergency department due to chest pain or other symptoms raising suspicion of acute myocardial infarction (AMI) in relation to whether they were hospitalized or directly discharged from the emergency department. ⋯ Of patients who came to the emergency department with acute chest pain or other symptoms suggestive of AMI about a third were directly discharged. Their mortality during the subsequent 10 years was half that of patients hospitalized. Various risk indicators for death were more strongly associated with prognosis in the patients who were directly discharged from the emergency department compared to those hospitalized. Of all patients given a diagnosis of confirmed or possible AMI, 1% were discharged from the emergency department. Their long-term mortality was high, maybe even higher than among AMI patients hospitalized.
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Coronary artery disease · Feb 2002
The effects of lipid-lowering therapy on low-density lipoprotein auto-antibodies: relationship with low-density lipoprotein oxidation and plasma total antioxidant status.
Oxidized low-density lipoprotein (Ox-LDL) is believed to play an important role in the progression of atherosclerosis. Oxidative modification of low-density lipoprotein (LDL) is a prerequisite for rapid accumulation of LDL in macrophages and for the formation of foam cells. Because of high antioxidant levels in plasma, LDL oxidation is suggested to occur mainly in the subendothelial space of the arterial wall, where there is the concomitant presence of large amounts of reactive oxygen species generated by endothelial cells and activated leukocytes. After Ox-LDL formation, antibodies against this form of LDL may occur. Auto-antibodies against Ox-LDL (AuAb-Ox-LDL) show directly in in-vivo LDL oxidation. Many studies have indicated that the amount of antibodies in serum is positively correlated to the rate of progression of atherosclerotic plaques. ⋯ It was concluded that lipid-lowering therapy may contribute to the reduction in levels of AuAb-Ox-LDL and the increase in the antioxidant capacity of plasma LDL and TAS. It was also suggested that the measurement of antibodies against Ox-LDL during lipid-lowering therapy may be used as an important marker for representing in-vivo LDL oxidation and atherosclerotic processes.