Stroke myocardial infarction and

The current consensus is that the contemporary low-dose preparations pose minimal risks in women who have no predisposing risk factors and, in fact, may provide certain beneficial health effects (e.g., protection against endometrial and ovarian cancer). Oral contraceptive pills have been associated with increased risk for myocardial infarction, stroke, and venous thromboembolism. However, studies have been published that suggest that these risks are minimal in appropriately chosen low-risk women. 

HMG Co-A reductase inhibitors (statins) have been shown to reduce the incidence of fatal and non-fatal myocardial infarction, stroke and mortality (all causes), as well as the need for coronary artery bypass surgery. Since no single drug has been shown to be significantly more effective or less expensive than others in the group, none is included in the model list the choice of drug for use in patients at highest risk should be decided at national level. 

Two forms of heparin-induced thrombocytopenia (HIT) have been observed. The first (HIT I) is a transient, mild, and benign thrombocytopenia seen soon after initiation of heparin therapy (normally within 2 days) and is felt to be due to inherent plateletaggregating properties of heparin. A second, more severe form of HIT (HIT II) is typically seen later and is immune-mediated. The incidence of HIT II is estimated at 3-5%. The onset is generally 3-14 days after initiation of heparin therapy but may occur sooner with repeat exposure. HIT II may occur with any dose and type of heparin, but the frequency is highest with continuous intravenous infusions of unfractionated heparin. HIT with subsequent thrombosis is a feared complication. These thrombi can form in the venous or arterial circulation. Thrombotic complications include necrotic skin lesions, myocardial infarction, stroke, and gangrene. Hyperkalemia may be seen with heparin therapy due to aldosterone synthesis inhibition. 

Ridker PM, Hennekens CH, Lindpaintner K, el al. Mutation in the gene coding for coagulation factor V and the risk of myocardial infarction, stroke, and venous thrombosis in apparently healthy men. NEngl J Med 1995 332(l4) 912-7. 

Cardiovascular diseases, comprising acute myocardial infarction, stroke, and venous thromboembolism, have, as their immediate underlying cause, thrombosis of critically situated blood vessels with loss of blood flow to vital organs. One approach to the treatment of thrombosis consists of pharmacologic dissolution of the blood clot via the intravenous infusion of plasminogen activators that activate the blood fibrinolytic system. 

ACE Inhibitors in Patients Who Are at High Risk of Cardiovascular Events Patients at high risk of cardiovascular events (no left ventricular dysfunction but evidence of vascular disease or diabetes and one other risk factor for cardiovascular disease) benefit considerably from ACE inhibitors, with significant decreases in the rates of myocardial infarction, stroke, and death. The benefits of ACE inhibition in patients at high risk of cardiovascular events persist even after coronary revascularization. 

Platelets provide the initial hemostatic plug at sites of vascular injury. They also participate in pathological thromboses that lead to myocardial infarction, stroke, and peripheral vascular thromboses. Potent inhibitors of platelet function have been developed. These drugs act by discrete mechanisms, and thus in combination their effects are additive or even synergistic. Their availabihty has led to a revolution in cardiovascular medicine, whereby angioplasty and vascular stenting of lesions now is feasible with low rates of restenosis and thrombosis when effective platelet inhibition is employed. 

Long-term data on the effect of sibutramine on obesity-related morbidity and mortahty are still lacking. However, the current Sibutramine Cardiovascular Outcomes (SCOUT) trial is evaluating the efficacy of sibutramine on major cardiovascular evmts (myocardial infarction, stroke, and mortality). It is planned that this study should be finished in 2008. 

No data on cardiovascular morbidity or mortality of rimonabant have still been reported but a large study investigating the effect of rimonabant on myocardial infarction, stroke, and cardiovascular death has been started. 

The SMQs consist of different adverse event terms with the objective to describe a common medical concept. In an attempt to increase the sensitivity of the assessment, it is quite common to combine search terms for medically closely related concepts, that is, to use a composite endpoint for the assessment of risks. A typical example of a composite safety endpoint is the major adverse cardiovascular events (MACE) criterion. This endpoint consists of myocardial infarction, stroke, and cardiovascular death. While this approach is very appealing at a first glance, great caution should be applied when using these composite endpoints. As in the case of MACE, the individual components of the composite do not necessarily have the same medical importance. Therefore, the results of the individual components of the composite should always be reported in addition to the overall result. This is particularly important if equivalence or noninferiority of the overall risk is to be claimed, and then it would also be interesting to know whether a treatment reduces the risk of stroke at the expense of an increased risk of cardiac mortality. 

Cardiovascular The use of glucocorticoids is associated with increased risks of myocardial infarction, stroke, and heart failure, but data are limited on the risk of atrial fibrillation and atrial flutter. In a case-control study patients with a first hospital diagnosis of atrial fibrillation or flutter were identified in Northern Denmark p "]. For each case 10 population controls matched by age and sex were selected. 

Atherosclerosis is the leading cause of morbidity and mortality in Westernized societies and is the underlying basis of myocardial infarction, stroke, and peripheral arterial disease (Libby, 2002). Atherosclerosis is a... 

The primary end-point during a median follow-up of 40 months was a composite of recurrent myocardial infarction, stroke and sudden death attributed to coronary artery disease. The authors conclude that treatment with B vitamins did not lower the risk of recurrent cardiovascular disease after acute myocardial infarction. 

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