Using logistic regression, the investigators evaluated the association between the lowest LAFI quartile and cardiovascular outcomes--including myocardial infarction, hospitalization for congestive heart failure, and
coronary disease death--and adjusted for potential confounding variables.
A score of 100-399 identifies men with a long-term risk high enough to warrant management by guidelines for secondary prevention of
coronary disease. But further testing for ischemia is usually not needed.
In October 1987, the NHLBI-administered National Cholesterol Education Program (NCEP) issued the now-controversial guidelines for gauging
coronary disease risk through blood lipid assays (SN: 10/17/87, p.254).
Over time,
coronary disease turned out to be 24% more prevalent in aviators whose fasting glucose fell into the newly defined impaired range of 101 110 mg/dL than in pilots with normal levels, Dr.
So what are the main symptoms of
coronary disease, and when should you seek medical assessment?
The strong inverse association between HDL cholesterol concentrations and risk of
coronary disease gave rise to the "HDL hypothesis"--namely that a therapy that increased concentrations of HDL might reduce risk of atherosclerotic disease.
Researchers said that people used to think that if someone had
coronary disease, they would eventually have a heart attack.
Furthermore, it has been frequently reported that diabetic patients may be clinically asymptomatic even with severe
coronary disease because of silent myocardial ischemia.
Results from a new analysis presented in a separate report at the meeting showed the superior cost-effectiveness of the same approach for patients with stable chest pain who are at low or intermediate risk for having
coronary disease, said Dr.
The researchers also found insufficient support for guidelines which advocate the high consumption of polyunsaturated fats (such as omega 3 and omega 6) to reduce the risk of
coronary disease.
When PCI is needed PCI is an important treatment for unstable heart disease and symptomatic
coronary disease that does not respond to drugs as well as for emergency situations, such as a heart attack.
Although proving a link between PTSD and
coronary disease requires more evidence, an immediate message from the results so far is that physicians, especially primary care physicians, should be more aware of the high prevalence of PTSD.
