European Journal of Cardiovascular Medicine

Atherosclerosis is the leading cause of death in developed countries. High density lipoproteins (HDL) cholesterol level correlates inversely with the risk of cardiovascular diseases. Thus, HDL has obtained lots of interest for drug development. In this review, we summarized the mechanisms for the antiatherogenic function of HDL, current HDL-based drugs in clinical use and the future direction for HDL-based therapy development.

Atherosclerosis is the leading cause of death in developed countries. High density lipoproteins (HDL) cholesterol level correlates inversely with the risk of cardiovascular diseases. Thus, HDL has obtained lots of interest for drug development. In this review, we summarized the mechanisms for the antiatherogenic function of HDL, current HDL-based drugs in clinical use and the future direction for HDL-based therapy development.

Chronic stable angina is a clinical expression of myocardial ischemia associated with xed atherosclerotic coronary stenosis, which prevents the adaptation of coronary circulation resulting in an increased oxygen requirement. We recommend that once the diagnosis of chronic stable angina is made, rst every patient should be offered the optimal medical therapy, including ACE inhibitors, beta-blockers, statins, and nitrates. If the patients’ symptoms are not controlled in spite of these drugs being used in maximum tolerated dosages, then these patients should be subjected to coronary angiography. If a patient shows a single- or double-vessel disease, then PCI should be offered. On the contrary, if the coronary angiogram shows a triple-vessel disease and left main disease, then one has to look for comorbidities that put the patient at a higher risk of CABG and the patient should be treated with PCI. Other patients with left main and triple-vessel disease having diabetes and left ventricular dysfunction should go directly for surgical revascularization. Overall, health related quality of life ( HRQoL) is similar in both PCI and CABG.

Introduction: Percutaneous coronary intervention (PCI) in coronary bifurcation lesions (CBL) is challenging and has poorer outcomes compared to non-bifurcation lesions. Conventional angiography alone is insufficient to assess procedural results because of poor resolution and complex anatomy involving bifurcations. We evaluate the use of optical coherence tomography (OCT) during bifurcation PCI to evaluate procedural results. Methods: This single-center, prospective, observational study included 13 patients with 14 CBLs undergoing PCI (one-stent or two-stent strategy) who were evaluated with OCT. After stent placement, OCT was used to assess acute stent malapposition, underexpansion, stent edge dissection, tissue protrusion, and microthrombi. To study malapposition in detail, bifurcation region was divided into four segments (proximal, distal and bifurcation segments of main vessel and side-branch segment). Results: The overall incidence of stent malapposition was 64%. It was more common with two-stent strategy compared to one-stent strategy (83% vs 50%). The incidence of malapposition was highest in side-branch and least in distal segment of main vessel. Stent underexpansion was seen in 21% of cases. Stent edge dissection, microthrombi, tissue prolapse were noted in 21% of cases. OCT findings led to additional interventional steps in 38% of cases. Conclusions: OCT can be used to comprehensively assess procedural results after bifurcation stenting. The incidence of acute stent malapposition is high after stenting at bifurcation sites and is more common when the two-stent techniques are used compared to the one-stent technique. Whether long-term clinical outcomes are affected by findings uncovered on OCT needs to be studied in prospective trials.

Rheumatic heart disease (RHD) is one of the common heart disease acquired in children in many regions of the world, mainly in developing and underprivileged countries. This heart condition occurs following rheumatic fever caused by streptococcal infection. It affects the functionality of heart valves. When untreated it may lead to medical complications and even death. The disease mainly targeting children and young adults is responsible for cardiovascular morbidity and mortality in people. Prevention and treatment of acute rheumatic fever plays an important role in controlling the disease. Diagnosis of the disease is critically important because misdiagnosis of acute rheumatic fever can lead to worsening of damage caused to heart valves and may also lead to premature death. This being a preventable problem, it can be managed through surgeries to repair functions of cardiac valves. Alcohol consumption and tobacco smoking has shown synergistic effect which may prove detrimental to cardiovascular health.