Anticoagulants ; therapeutic use ; Coronary Artery Disease ; prevention & control ; Humans

Colchicine/therapeutic use* ; Coronary Artery Disease ; Coronary Disease/prevention & control* ; Humans ; Plaque, Atherosclerotic

Coronary heart disease is a kind of heart disease that is caused by atherosclerosis. The lipid deposition in the vessel wall results in occlusion of coronary artery and stenosis, which could induce myocardial ischemia and oxygen deficiency. Intervention therapies like percutaneous coronary intervention (PCI) and coronary stent improve myocardial perfusion using catheter angioplasty to reduce stenosis and occlusion of coronary artery lumen. Accordingly, intervention therapies are widely applied in clinic to treat ischemic cardiovascular disease, arterial intima hyperplasia and other heart diseases, which could save the patients' life rapidly and effectively. However, these interventions also damage the original endothelium, promote acute and subacute thrombosis and intimal hyperplasia, and thus induce in-stent restenosis (ISR) eventually. Studies indicated that the rapid reendothelialization of damaged section determined postoperative effects. In this review, reendothelialization of implants after intervention therapy is discussed, including the resource of cells contributed on injured artery, the influences of implanted stents on hemodynamic, and the effects of damaged degree on reendothelialization.
Angioplasty, Balloon, Coronary ; Cardiac Catheterization ; Coronary Artery Disease ; therapy ; Coronary Restenosis ; prevention & control ; Endothelium, Vascular ; pathology ; Humans ; Myocardial Ischemia ; prevention & control ; Stents ; Thrombosis ; prevention & control

Treatment of dyslipidemia is apparently one of the most important measures for prevention of atherosclerotic cardiovascular diseases. Recent trend reflecting several study results after publication of the ATP-III guideline in 2001 recommends more aggressive target LDL goals in very high risk patients. On the other hand, public health approaches, such as life style modification, to low risk group should not be neglected for primary prevention to avoid life-long medication in undesirably large number of people. Intensity of the treatment must be adjusted after a careful consideration of each patient's global risk, not just by lipid level alone. More attention to dyslipidemia management is needed for both clinical and public health perspectives.
Cardiovascular Diseases ; Coronary Artery Disease ; Dyslipidemias ; Hand ; Humans ; Life Style ; Primary Prevention ; Public Health ; Publications

BACKGROUND AND OBJECTIVES: Despite the proven benefit of cholesterol- lowering therapy in patients with CAD, there is no consensual opinion on guideline of cholesterol-lowering therapy in patients with CAD in Korea. The aim of this study is to evaluate the risk of CAD according to the cholesterol level and to consider current guideline of cholesterol-lowering therapy for the secondary prevention in patients with CAD. MATERIALS AND METHODS: Consecutive 600 patients were assigned into two groups - coronary artery disease group (364 patients) and normal coronary artery group (236 patients) - depending on the coronary angiographic findings. Lipid profiles (total cholesterol, Triglyceride, HDL-cholesterol, LDL-cholesterol) were obtained and the odd ratio of CAD was evaluated according to the national cholesterol education program treatment guideline (NCEP: LDL cholesterol > or = 130 mg/dl) and the national heath insurance treatment guideline (NHI: total cholesterol > or = 220 mg/dl) by multi-variate logistic regression analysis. RESULTS: According to the NHI and NCEP guideline, the proportion of patients with CAD indicated on cholesterol-lowering therapy were 25%, 36.5% respectively and the odd ratio of CAD was 1.00 (95% CI 0.52 - 1.89, p=0.99), 4.89 (95% CI 2.78 - 8.60, p< 0.01) respectively . CONCLUSIONS: Our data showed that LDL-cholesterol > or = 130 mg/dl only reflected the risk of CAD in both guidelines and more proportion of the patients were indicated on cholesterol-lowering therapy in NCEP guideline than in NHI guideline.
Cholesterol ; Cholesterol, LDL ; Coronary Artery Disease* ; Coronary Vessels* ; Education ; Humans ; Insurance ; Korea ; Logistic Models ; Secondary Prevention ; Triglycerides

PURPOSE: The purpose of this study was to analyze the research on adherence for secondary prevention in patients with coronary artery disease (CAD) in Korea, and to identify the strategies for improvement that should be included in future studies. METHODS: Electric literature searches were conducted for Pubmed, CINAHL, RISS4U, KISTI, DBpia, KoreaMed, National Assembly Library, and National Library of Korea. A total of forty two articles published between 1986 and 2009 were selected based on established inclusion criteria. RESULTS: Forty research papers were related to nursing, and there was only one research paper focused on elderly people with CAD. There were no papers using concept analysis, qualitative study, or randomized controlled clinical trial. Almost all definitions of adherence were adopted from outdated compliance definitions with the attribute of 'paternalistic obligation'. Measurement tools were not based on theoretical framework of adherence but borrowed from tools for measuring self-care, health behavior, or self-efficacy. Overall patient's adherence was analyzed in most studies, except for a few studies which focused on diet and exercise only. Educational strategy was the main strategy used in intervention studies. CONCLUSIONS: The concept of adherence and measurement tools need to be clarified, along with development of the specific adherence interventions according to the type of adherence in patients with CAD.
Aged ; Compliance ; Coronary Artery Disease ; Coronary Vessels ; Diet ; Health Behavior ; Humans ; Clinical Trial ; Korea ; Patient Compliance ; Secondary Prevention ; Self Care

Cardioprotective effect and the safety of 3-hydroxy-3-methylglutaryl-coenzyme A reductase inhibitors (statins) has been established in many large-scaled randomized controlled trials encompassing both primary and secondary prevention. Therefore, the market of statins is growing rapidly. In new millennium, several studies have shown the benefit from further reducing already low concentration of low density lipoprotein-cholesterol in high-risk patients. However, these clinical trials have applied selection criteria to protect the internal validity at the expense of reducing the applicability of the trial's findings to the wider population of patients seen in routine clinical practice. Treatment guideline for Korean hypercholesterolemic patients followed that of American. However, the death rate by coronary artery diseases is much lower in Korean population than in American population. The efficacy of statins in preventing cardiovascular diseases and the pitfalls in recent randomized controlled trails will be reviewed and the personal opinion for the management of Korean hypercholesterolemic patients will be suggested.
Cardiovascular Diseases ; Coronary Artery Disease ; Humans ; Hydroxymethylglutaryl-CoA Reductase Inhibitors ; Hypercholesterolemia* ; Mortality ; Oxidoreductases ; Patient Selection ; Primary Prevention ; Secondary Prevention

Cardiovascular diseases are well known to be associated with several psychiatric illnesses. Most of the related psychological problems were type A personality, stress related problems, anxiety, and depressive illnesses. The dimensions of the associations are various from risk factor to triggering factor. With recent advances in the understanding of the mechanisms of heart attacks, the pathogenesis model by type A personality or depression might be associated with both longstanding atherogenic components or risk factors and decisive momentum to trigger the heart attack. Accordingly, in addition to the management of the unhealthy behavior related to the type A personality, intervention for the acute psychologic crisis might be equally important. Moreover, the association between the type A personality and cardiovascular diseases is observed in the primary prevention as well as secondary prevention studies. Due to the nature of the associated psychological problems, the background of the social environments seems to be deeply involved in the associations. The understanding of the complexity of the association is the key to further studies.
Anxiety ; Cardiovascular Diseases ; Coronary Artery Disease* ; Depression ; Heart ; Primary Prevention ; Risk Factors ; Secondary Prevention ; Social Environment ; Type A Personality*

BACKGROUND AND OBJECTIVES: The National Cholesterol Education Program-Adult Treatment Panel (NCEP-ATP) III guideline has been widely accepted for the primary prevention of coronary heart disease (CHD). The coronary artery calcium score (CACS) has recently been recognized as an excellent predictor of CHD events, and a primary prevention strategy based on the CACS [the Screening for Heart Attack Prevention and Education (SHAPE) guideline] has been proposed. The purpose of this study was to explore how the guidelines function for asymptomatic South Korean individuals. SUBJECTS AND METHODS: We consecutively enrolled 2,079 asymptomatic subjects (age range for men: 45-75 years, age range for women: 55-75 years) who underwent CACS and coronary CT angiography (CCTA) as a part of a health check-up. We analyzed the differences of the target population for CHD prevention according to the 2 guidelines and we compared them in terms of the presence of occult CHD. RESULTS: Four-hundred eighteen (20%) individuals were recommended for pharmacotherapy according to the NCEP-ATP III and 371 (18%) were recommended for pharmacotherapy according to the SHAPE guideline (Cohen's kappa=0.36). According to the SHAPE guideline, more individuals with significant stenosis noted on the CCTA were categorized into the high or very high risk group (50% vs. 24%, respectively, p<0.001) and recommended for pharmacotherapy (53% vs. 28%%, respectively, p<0.001). However, 57 (43%) individuals with significant stenosis on the CCTA were not suitable for pharmacotherapy according to either the NCEP-ATP III or the SHAPE guideline. CONCLUSION: Comparing the NCEP-ATP III and the SHAPE guidelines, there were considerable differences for primary prevention in the target population. Although SHAPE might provide more accurate stratification in terms of the presence of occult CHD, a more precise risk stratification algorithm needs to be implemented for this population.
Angiography ; Calcium ; Cholesterol ; Constriction, Pathologic ; Coronary Artery Disease ; Coronary Disease ; Coronary Vessels ; Health Services Needs and Demand ; Heart ; Mass Screening ; Primary Prevention

The role of platelets is well known in the atherogenesis, acute coronary syndrome and development of complications of percutaneous coronary intervention. Until recently, aspirin was the only antiplatelet agent available for the primary and secondary prevention of coronary heart disease. Over the past several years, there has been a substantial expansion in our antiplatelet armamentarium, as well as in our understanding of the clinical importance of antiplatelet therapy in patients with coronary artery disease. The benefits and limitations of the currently available antiplatelet agents, including aspirin, thienopyridines (ticlopidine and clopidogrel) and the platelet glycoprotein IIb/IIIa blockers, in the secondary prevention of coronary heart disease, and high-risk clinical situations, such as unstable angina, acute myocardial infarction and percutaneous coronary intervention, have been reported. Antiplatelet agents should be used, in proper combination, in all relevant cases, as they have been shown to improve the prognosis of various forms of high-risk patients with coronary artery disease.
Acute Coronary Syndrome ; Angina, Unstable ; Angioplasty, Balloon, Coronary ; Aspirin ; Atherosclerosis ; Blood Platelets ; Coronary Artery Disease* ; Coronary Disease ; Coronary Vessels* ; Glycoproteins ; Humans ; Myocardial Infarction ; Percutaneous Coronary Intervention ; Platelet Aggregation Inhibitors* ; Prognosis ; Secondary Prevention ; Thienopyridines