9. Coronary Prevention Flashcards
coronary heart disease is essentially a subset of what condition?
atherosclerosis
what is the most common single disease cause of death in the US?
coronary heart disease
for CAD, what are men more likely to present with? women?
Men: AMI
women: angina pectoris (chest pain due to ischemia of heart muscle)
atherosclerosis is seen to involve an ongoing ______ repsonse
inflammatory
what are seen in the earliest lesions of atherosclerosis?
leukocytes, CRP (inflammatory markers)
what is the problem that plaques present with atherosclerosis?
may become vulnerable through thinning of the fibrous cap, then possibly rupture
what happens when a plaque rupturs?
exposes tissue factor to the circulating blood, generating further inflammation and inciting hemostatic/thrombotic processes. either enlargement of the plaque or sudden occlusion of the lumen.
sum up cardiac events in 3 points:
- early atherogenesis
- progression mediated by inflammation
- acute thrombus
what are the 4 stages of atherosclerosis?
- fatty streaks
- fibrous plaques (enlarge with behavior, low level inflammation)
- occlusive atherosclerotic plaque. (exertion angina, intermittent claudication)
- plaque rupture, fissure, thrombosis.
what are the top 3 major, modifiable risk factors of coronary disease?
-HTN, smoking, hypercholesterol
risk factors are additive or synergistic?
synergistic
what are the parameters of metabolic syndrome?
- abdominal obesity
- hypertriglycerides
- small LDL
- low HDL
- HTN
- insulin resistance
what does the ATP III Risk Assessment Tool calculate? based on what parameters?
calculates 10 year risk of a coronary event. based on age, gender, total and HDL chol, smoking status, BP
what are the recommendations of teh ATP III expert panel in terms of changing risk factors?
Behavioral stuff: TLC = therapeutic lifestyle change. exercise, diet, smoking cessation, drug compliance.
what drugs have been shown to produce the greatest decr in LDL cholesterol and in coronary mortality?
statins (chol-lowering)
