SummaryBackground: Complementary and alternative medicine (CAM) use is common among patients with cardiovascular disorders and is generally underrecognized by physicians. The attitudes of these patients regarding these therapies and their perceptions of safety and efficacy have not been well defined.Methods: A written survey was received from a cohort of outpatients seen at a large outpatient cardiovascular clinic in Texas. Over 75% of patients responded, with more than 90% of returned surveys adequate for analysis.Results: Of the 210 respondents 113 admitted to CAM use, with Vitamins E and C being the most frequently utilized agents. Women were significantly more likely to take CAM than men (69 vs. 46%, p = 0.002), particularly those taking hormone replacement therapy. Over half of patients surveyed stated their cardiologist was unaware of their use of CAM. Only 15% of patients felt that CAM was more efficacious than their traditional medications, but almost half felt it was significantly safer. A similar number were unaware of any interactions between CAM and their other medications.Conclusions: Use of CAM is common in cardiology outpatients, and many patients remain unaware of potential health risks. Physicians should routinely question patients about use of CAM and attempt to educate users regarding potential health risks.
Introduction-Patients with renal insufficiency have an increased risk of atherosclerotic coronary artery disease, cardiovascular events, and sudden cardiac death. Due to under-representation of patients with renal disease in large clinical trials, outcomes of implantable cardioverter defibrillator (ICD) implantation in this group remain unclear.
Background: Extracellular matrix remodeling is a component of coronary artery disease (CAD). Matrix metalloproteinases (MMPs) are enzymes involved in extracellular matrix degradation. The extrapolation of the role MMPs play in the clinical setting of acute coronary syndromes has not yet been defined.
Methods: Samples from 100 subjects undergoing cardiac catheterization were analyzed for serum levels of MMP‐1, MMP‐2, and MMP‐9. These markers were assessed before, immediately after, and 24 hours after cardiac catheterization. Relationships among MMP levels, baseline characteristics, angiography findings and clinical course were assessed.
Results: Comparing subjects with myocardial infarction versus those without, baseline MMP‐1 levels were not different at baseline but increased during the hospital stay, MMP‐2 levels were higher at baseline and throughout the monitoring period and MMP‐9 levels lower and decreased over time. MMP‐1 was higher 24 hours after catheterization in subjects undergoing revascularization. Subjects undergoing percutaneous revascularization had higher MMP‐9 levels following revascularization than those subjects undergoing angiography without angioplasty.
Conclusions: Serial monitoring of MMPs indicates a differential subtype response to myocardial infarction and percutaneous revascularization. Results of this study indicate that MMP subtypes may play differing roles in the manifestation of acute coronary syndromes and response to revascularization. (J Interven Cardiol 2004;17:27–31)
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