Cardiovascular Medicine

2 pages, 176 KB

Open AccessInteresting Images

Dreidimensionale Angiosonographie

by Michel Zuber

Cardiovasc. Med. 2004, 7(11), 423; https://doi.org/10.4414/cvm.2004.01059 - 24 Nov 2004

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Viele Gefässsysteme lassen... Full article

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2 pages, 183 KB

Open AccessCase Report

Long QT

by Micha Maeder and Hans Rickli

Cardiovasc. Med. 2004, 7(11), 421; https://doi.org/10.4414/cvm.2004.01054 - 24 Nov 2004

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34jährige Patientin, .... Full article

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7 pages, 198 KB

Open AccessArticle

Kosten-Effektivität von Atorvastatin bei Patienten Mit Akutem Koronarsyndrom–Eine Analyse der PROVE IT-Studie

by Thomas D. Szucs and Bernhard Meier

Cardiovasc. Med. 2004, 7(11), 412; https://doi.org/10.4414/cvm.2004.01058 - 24 Nov 2004

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Abstract

Background:As part of the PROVE IT-TIMI 22 study the effects of therapy with 40 mg/day pravastatin (aim: standard reduction of a low density lipoprotein [LDL] to 100 mg/dL or 2.6 mmol/L) were compared with those of intensified lipid lowering with 80 mg/day atorvastatin (aim: lowering to 70 mg/dl or 1.8 mmol/L) in patients after acute coronary syndrome. In patients on the more intensive statin therapy with 80 mg/day, greater protection against death or a major cardiovascular event was observed (–25%) than in patients on pravastatin 40 mg/day. The evidence provided by the PROVE IT study of the clinical effectiveness of atorvastatin in an intensified dose of 80 mg/ day in patients with coronary disease affords an opportunity of calculating the cost effectiveness of secondary prevention in this population and of this treatment pattern in Switzerland. Patients and methods: The cost effectiveness of atorvastatin in secondary prevention was investigated on the basis of the results of the PROVE IT study and applied to the Swiss health care system from the third party perspective by means of an incremental cost effectiveness analysis. Effectiveness was expressed as life years gained and computed by epidemiological modelling. Costs and effectiveness were verified by univariate sensitivity analysis. Results: The additional life years gained by atorvastatin therapy compared with pravastatin amount to 0.123 years per patient. The resultant cost effectiveness of atorvastatin in Switzerland is CHF 3075 (1997 euro) per life year gained. The costs compared with pravastatin therapy are, discounted, CHF 380 (247 euro) per patient on atorvastatin therapy. If, annually, half of all patients with acute coronary syndrome received intensive lipid lowering with 80 mg/day atorvastatin instead of the conventional dosage of 40 mg/day pravastatin, 68 human lives with 1120 life years would be saved each year in Switzerland. Conclusion: Intensive lipid lowering therapy with atorvastatin in patients following an acute coronary event can be regarded as cost effective in Switzerland. Full article

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5 pages, 171 KB

Open AccessProceeding Paper

Myocardial Infarction and Glucose-Insulin-Potassium Infusion: An Overview

by Jorik R. Timmer, Iwan C. C. van der Horst, Jan Paul Ottervanger, Arnoud W. J. van 't Hof, Henk J. G. Bilo and Felix Zijlstra

Cardiovasc. Med. 2004, 7(11), 406; https://doi.org/10.4414/cvm.2004.01055 - 24 Nov 2004

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Abstract

Background: Mortality and infarct size in ST segment elevation myocardial infarction (STEMI) may be reduced by therapies influencing myocardial metabolism, such as infusion of glucose-insulin-potassium (GIK). Although several clinical trials with GIK have been performed, the effect of GIK on outcome is still uncertain. In this article a review of all randomised trials on GIK infusion in STEMI is given. Methods and Results: We identified randomised trials comparing GIK with placebo or controls in STEMI patients by electronic and manual searches. Thirteen trials were included with a total of 4992 patients. Overall, hospital mortality was lower after GIK (10.8% vs 12.9%, p = 0.02). Particularly high-dose GIK infusions were effective and if given as adjunctive to reperfusion therapy. GIK may have worse effects in patients with heart failure on admission. GIK infusion caused only mild adverse effects. Fluid overload may be a problem in certain patients. Conclusions: GIK may reduce mortality in patients with STEMI. GIK is particularly effective when a high dose is used and when administered as adjunctive to reperfusion therapy. However, definite conclusions cannot be made and additional large randomised trials are needed. Full article

10 pages, 220 KB

Open AccessProceeding Paper

Physical Activity in the Prevention of Type 2 Diabetes

by Gang Hu, Timo A. Lakka, Noël C. Barengo and Jaakko Tuomilehto

Cardiovasc. Med. 2004, 7(11), 394; https://doi.org/10.4414/cvm.2004.01056 - 24 Nov 2004

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Abstract

Type 2 diabetes is a common chronic disease with multiple complications, most notably cardiovascular diseases. In the past decade, the associations of physical activity, physical fitness, and changes in the lifestyle with the risk of type 2 diabetes have been assessed by a number of prospective studies and clinical trials. A few studies also evaluated joint associations of physical activity, Body Mass Index and glucose levels with the risk of type 2 diabetes. The results based on 21 prospective studies and four clinical trials have shown that moderate or high levels of physical activity or physical fitness, and changes in the lifestyle (dietary modification and increase in physical activity) can prevent type 2 diabetes. Not only leisure-time physical activity, but also occupational and commuting physical activities are important components of healthy lifestyle and can protect against type 2 diabetes. Full article

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5 pages, 193 KB

Open AccessEditorial

Der Herzinfarkt: Vom Schicksal zur Krankheit

by Thomas F. Lüscher, L. Altwegg and F. H. Messerli

Cardiovasc. Med. 2004, 7(11), 386; https://doi.org/10.4414/cvm.2004.01057 - 24 Nov 2004

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Am Anfang gab... Full article

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Cardiovasc. Med., Volume 7, Issue 11 (11 2004) – 6 articles

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